Can Recovery From an Eating Disorder Be Measured? Toward a Standardized Questionnaire

Background: There is a clear need for a standardized definition of recovery from eating disorders (EDs) and for self-report instruments to assess where individuals with an ED are situated at a given point of time along their process of illness and recovery. It has been acknowledged that psychological and cognitive symptoms are important to recovery in addition to physical and behavioral indices. This study proposes a 28-item multidimensional questionnaire encompassing the main features of recovery from ED, derived from the endorsement of different criteria by people with a lifetime ED diagnosis, family members and ED clinicians.Methods: Participants were 213 volunteers over the age of 18 (118 people with a lifetime ED diagnosis, 58 healthy family members of people with EDs and 37 ED clinicians), who completed the ED-15 and indicated online how important they thought each of 56 criteria were for recovery from an ED.Results: Four factors were identified in an exploratory factor analysis: Lack of Symptomatic Behavior (LSB), Acceptance of Self and Body (ASB), Social and Emotional Connection (SEC), and Physical Health (PH). Confirmatory factor analysis using the seven highest loading items from each subscale confirmed the structure validity of a shortened version of this questionnaire, the Eating Disorders Recovery Endorsement Questionnaire (EDREQ), which had excellent goodness-of-fit indices. Despite a few between-group differences, there was general agreement that LSB was most salient to recovery, followed by ASB, SEC, and PH in that order.Conclusion: Despite the absence of a standardized definition of recovery from ED, there is a general consensus about its components. The EDREQ is a psychometrically sound questionnaire containing items that people with an ED history, their family members and therapists all define as important components of recovery. The inclusion of emotional and psychosocial aspects of recovery in addition to symptomatic and medical aspects is important to expand treatment goals and the concept of recovery from EDs beyond symptom relief and the absence of disease markers. As a clinical tool, the EDREQ stands to assist in setting and refining therapeutic goals throughout therapy, and in establishing standardized, comparable norms for recovery levels in research

Lives on the Line: The Online Lives of Girls and Women With and Without a Lifetime Eating Disorder Diagnosis

This study aimed to compare the scope, internet use patterns, and degree of online need satisfaction of girls and women with and without a lifetime eating disorder (ED) diagnosis. Participants were 122 females aged 12–30, 53 with a lifetime ED diagnosis recruited via a hospital-based treatment program, and 69 age-matched controls recruited via normative social media sites. Participants completed questionnaires assessing disordered eating, body image, positive and negative affect, general distress, and life satisfaction, and completed an online survey about the scope of their internet use, the frequency of watching and posting pictures and videos, online friendships and social comparison, fulfillment of needs online, and mood after internet use. All questionnaire scores differed significantly between groups in the expected directions. Whereas overall, ED and control groups spent similar amounts of time online (6.21, SD = 5.13), they spent this time differently. ED participants reported devoting 56.7% of their online time to eating, weight and body image, versus 29.1% for controls, and spent significantly more time than controls on forums and blogs (t = -5.3, p < 0.0001, Cohen’s d = 0.87). They also engaged more often in social comparison (t = 3.6, p < 0.005, Cohen’s d = 0.65), had a higher online–offline friend ratio (t = 3.7, p < 0.0001, Cohen’s d = 0.65), and more online friends with ED (t = 5.4, p < 0.0001, Cohen’s d = 0.89). In comparison to controls, ED participants reported that their use of forums and blogs gave them more eating- and weight-related advice, and a greater sense of belonging, social support, and safety resulting from anonymity, with effect sizes of 0.63–0.96. However, they also reported more negative affect after posting online. Most online behaviors and patterns correlated positively with measures of symptomatology and negatively with measures of psychological health, in both groups. Internet use was rarely addressed in therapy. Professionals, families and friends should help people with disordered eating and EDs to broaden the scope of their internet use. They should invest less in food- and weight-related forums/blogs, expand their “real life” social lives and develop their interpersonal skills, so that their legitimate needs can be satisfied face-to-face, rather than virtually. Clinicians should address the online lives of their ED clients in therapy

The Oxytocin Receptor (OXTR) Contributes to Prosocial Fund Allocations in the Dictator Game and the Social Value Orientations Task

Background: Economic games observe social decision making in the laboratory that involves real money payoffs. Previously we have shown that allocation of funds in the Dictator Game (DG), a paradigm that illustrates costly altruistic behavior, is partially determined by promoter-region repeat region variants in the arginine vasopressin 1a receptor gene (AVPR1a). In the current investigation, the gene encoding the related oxytocin receptor (OXTR) was tested for association with the DG and a related paradigm, the Social Values Orientation (SVO) task. Methodology/Principal Findings: Association (101 male and 102 female students) using a robust-family based test between 15 single tagging SNPs (htSNPs) across the OXTR was demonstrated with both the DG and SVO. Three htSNPs across the gene region showed significant association with both of the two games. The most significant association was observed with rs1042778 (p = 0.001). Haplotype analysis also showed significant associations for both DG and SVO. Following permutation test adjustment, significance was observed for 2–5 locus haplotypes (p,0.05). A second sample of 98 female subjects was subsequently and independently recruited to play the dictator game and was genotyped for the three significant SNPs found in the first sample. The rs1042778 SNP was shown to be significant for the second sample as well (p = 0.004, Fisher’s exact test). Conclusions: The demonstration that genetic polymorphisms for the OXTR are associated with human prosocial decisio

Enjoying your body: The psychometric properties of an English version of the Dresden Body Image Questionnaire

Objective We present a measure of positive body experiences. The purpose of this study was to validate an English translation of the Dresden Body Image Questionnaire (DKB‐35), designed to assess positive body experiences and to examine whether its subscales moderate the relationship between BMI and eating and body problems. Method An English version of the DKB‐35 was administered to 228 men and women aged 18–73, who also completed measures of body dissatisfaction, disordered eating and life satisfaction, and reported height and weight. Results The psychometric properties of the DKB‐35 were satisfactory. DKB‐35 subscale scores (Vitality, Body Acceptance, Body Narcissism, Physical Contact, and Sexual Fulfillment) correlated positively with life satisfaction and negatively with disordered eating and body dissatisfaction. Of the five subscales, only Body Acceptance correlated significantly with BMI. Body Narcissism and Physical Contact were significant moderators of the association between BMI and disordered eating. For people with low, but not high BMIs, low scorers on Body Narcissism or Physical Contact had higher levels of disordered eating and body dissatisfaction. In a regression analysis predicting life satisfaction scores with BMI and the DKB‐35 subscales, the Body Acceptance, Vitality, and Sexual Fulfillment subscales were positive predictors. Conclusions These results support the use of the DKB‐35 in English. Body acceptance, vitality, sexual fulfillment, body narcissism, and physical contact are positive body experiences measured by this scale

Intergenerational Transmission of Child Feeding Practices

This study assessed the relationships between parents’ retrospective recollections of their mothers’ child feeding practices (CFP), current disordered eating (DE) and current CFP (how they now feed their children). 174 Israeli parents (136 mothers, 38 fathers; 40.1 ± 6.9 years of age) of children between the ages of 2 and 18, living at home, completed questionnaires online assessing demographics, retrospective recollections of the CFP that their mothers used when they were children, current CFP and current DE. Specific aspects of retrospectively recalled maternal CFP were significantly associated with the same aspects of current CFP. Current DE mediated the association between retrospectively recalled maternal CFP and current CFP and moderated the association between current concern about child’s weight and pressure for child to eat. Results highlight that the way adults pass on their feeding practices to their children is strongly influenced by their childhood recollections of their mothers’ concern about their weight, pressure for them to eat or restriction of their food intake. People often strive to behave differently from their parents, especially in the realm of food and eating. However, our findings suggest that parental CFP can become entrenched and can be passed on to our children

How anorexic-like are the symptom and personality profiles of aesthetic athletes?

Contains fulltext : 178385pub.pdf (publisher's version ) (Open Access) Contains fulltext : 178385pre.pdf (preprint version ) (Open Access

Trauma, Post-Traumatic Stress Disorder, and Mental Health Care of Asylum Seekers

Asylum seekers in Israel from East Africa frequently experienced traumatic events along their journey, particularly in the Sinai Peninsula, where they were subjected to trafficking and torture. Exposure to trauma has implications for rights that are contingent on refugee status. This retrospective chart review aimed to characterize the types of traumas experienced by 219 asylum seekers (149 men) from Eritrea and Sudan who sought treatment at a specialized mental health clinic in Israel, and to compare the mental health of trauma victims (n = 168) with that of non-trauma victims (n = 53). About 76.7% of the asylum seekers had experienced at least one traumatic event, of whom 56.5% were diagnosed with post-traumatic stress disorder (PTSD). Most reported traumas were experienced en route in the Sinai, rather than in the country of origin or Israel. Few clinical differences were observed between trauma victims and non-trauma victims, or between trauma victims with and without a PTSD diagnosis. Our findings emphasize the importance of accessibility to mental and other health services for asylum seekers. Governmental policies and international conventions on the definition of human trafficking may need to be revised, as well as asylum seekers’ rights and access to health services related to visa status