Impact of COVID-19 lockdown in eating disorders: a multicentre collaborative international study

The COVID-19 lockdown has had a significant impact on mental health. Patients with eating disorders (ED) have been particularly vulnerable. Aims. (1) To explore changes in eating-related symptoms and general psychopathology during lockdown in patients with an ED from various European and Asian countries; and (2) to assess differences related to diagnostic ED subtypes, age, and geography. Methods. The sample comprised 829 participants, diagnosed with an ED according to DSM-5 criteria from specialized ED units in Europe and Asia. Participants were assessed using the COVID-19 Isolation Scale (CIES). Results. Patients with binge eating disorder (BED) experienced the highest impact on weight and ED symptoms in comparison with other ED subtypes during lockdown, whereas individuals with other specified feeding and eating disorders (OFSED) had greater deterioration in general psychological functioning than subjects with other ED subtypes. Finally, Asian and younger individuals appeared to be more resilient. Conclusions. The psychopathological changes in ED patients during the COVID-19 lockdown varied by cultural context and individual variation in age and ED diagnosis. Clinical services may need to target preventive measures and adapt therapeutic approaches for the most vulnerable patientsFondo Investigación Sanitario-FIS, Grant/Award Numbers: FIS, INT19/00046, PI17/01167; Ministerio de Economía y Competitividad, Grant/Award Number: PSI2015-68701-R; Portuguese Foundation for Science and Technology grant, Grant/Award Number: POCI-01-0145-FEDER-028145; Consejo Nacional de Ciencia y Tecnología; Generalitat de Catalunya; European Regional Development Fun

Impact of COVID-19 Lockdown in Eating Disorders: A Multicentre Collaborative International Study

Trastorns de l'alimentació; Impacte psicològic; Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; ConfinamentTrastornos de la alimentación; Impacto psicológico; Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; ConfinamientoEating Disorders; Psychological impact; Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; ConfinementBackground: The COVID-19 lockdown has had a significant impact on mental health. Patients with eating disorders (ED) have been particularly vulnerable. Aims: (1) To explore changes in eating-related symptoms and general psychopathology during lockdown in patients with an ED from various European and Asian countries; and (2) to assess differences related to diagnostic ED subtypes, age, and geography. Methods: The sample comprised 829 participants, diagnosed with an ED according to DSM-5 criteria from specialized ED units in Europe and Asia. Participants were assessed using the COVID-19 Isolation Scale (CIES). Results: Patients with binge eating disorder (BED) experienced the highest impact on weight and ED symptoms in comparison with other ED subtypes during lockdown, whereas individuals with other specified feeding and eating disorders (OFSED) had greater deterioration in general psychological functioning than subjects with other ED subtypes. Finally, Asian and younger individuals appeared to be more resilient. Conclusions: The psychopathological changes in ED patients during the COVID-19 lockdown varied by cultural context and individual variation in age and ED diagnosis. Clinical services may need to target preventive measures and adapt therapeutic approaches for the most vulnerable patients

Neuroendocrinological factors in binge eating disorder: A narrative review

Neuroendocrine mechanisms play a key role in the regulation of eating behavior. In individuals with binge eating disorder (BED), alterations in these mechanisms signaling hunger and satiety have been observed. It has been investigated that these alterations may underlie the development and maintenance of compulsive overeating in BED. The present narrative review examined the current literature related to the neurobiological processes involved in feeding dysregulation in BED with the aim of updating the most relevant aspects with special attention to neuroendocrine signaling. Studies have shown both central and peripheral endocrine dysfunctions in hormones participating in homeostatic and hedonic pathways in BED. Most studies have been especially focused on orexigenic signals, pointing out the existence of a hyperactivated mechanism promoting hunger. Fewer studies have explored anorexigenic pathways, but the findings so far seem to suggest an abnormal satiety threshold. Despite this, to date, it is unable to identify whether these alterations are typical of the BED patho-physiology or are related to an obesogenic pattern due to most studies included patients with BED and obesity. The identification of endophenotypes in BED may provide a new approach to aberrant eating behavior, favoring the implementation of biological therapeutic targets

Biofeedback Interventions for Impulsivity-related Processes in Addictive Disorders

Purpose of Review Biofeedback is a promising technique that has been used as a treatment tool for different psychological disorders. In this regard, central (neurofeedback) and peripheral psychophysiological signals are presented as comprehensible stimuli with the aim of training specific processes. This review summarizes recent evidence about its use for the treatment of impulsivity-related processes in addictive disorders. Recent Findings Neurofeedback (NFB) protocols, based on electroencephalography (EEG) and functional magnetic resonance imaging (fMRI), have focused on substance use disorders. Biofeedback protocols using peripheral measures have been mainly based on heart rate variability and focused on behavioral addictions. EEG-NFB reported good results in the reduction of hyperarousal, impulsivity and risk taking in alcohol use disorder, and decreased rates of smoking and less craving in nicotine addiction. In fMRI-NFB, effective NFB performance has been related with better clinical outcomes in substance use disorders; however, its implication for treatment is still unclear. Heart rate variability biofeedback results are scarce, but some interventions have been recently designed aimed at treating behavioral addictions. Summary In addictive disorders, biofeedback interventions for impulsivity-related processes have shown promising results, although the literature is still scarce. Further research should aim at proving the effectiveness of biofeedback protocols as a treatment option for impulsivity in addictive disorders

Implementación de metodologías de evaluación continua: aplicación en la asignatura de Cálculo Numérico

La creación del nuevo Espacio Europeo de Educación Superior, con los consiguientes cambios en la estructura y contenidos de las titulaciones universitarias, ofrece una gran oportunidad para revisar las metodologías de aprendizaje, estando las metodologías de evaluación continua en una creciente expansión. El objetivo de este trabajo es investigar el efecto que tiene en el aprendizaje de los estudiantes diferentes metodologías de evaluación continua. Para ello, varios tipos de evaluación periódica (entrega de trabajos grupales y/o individuales, exámenes parciales, etc.) han sido puestos en práctica en la asignatura de Cálculo Numérico del último curso de la Licenciatura de Matemáticas y actual Grado de Matemáticas, a lo largo de un total de 14 años académicos en la Universidad de Alicante. En esta comunicación presentaremos las diferentes estrategias de desarrollo de los contenidos de la asignatura así como la forma de evaluación de los mismos. Además, se hará un análisis descriptivo de los resultados obtenidos con las distintas metodologías empleadas y se recogerán propuestas de mejora de cara al próximo curso

Lifetime Weight course as a phenotypic marker of severity and therapeutic response in patients with eating disorders

The association between lifetime weight fluctuations and clinical characteristics has been widely studied in populations with eating disorders (ED). However, there is a lack of literature examining the potential role of weight course as a transdiagnostic factor in ED so far. Therefore, the aim of this study is to compare ED severity and treatment outcomes among four specific BMI profiles based on BMI-trajectories across the lifespan: (a) persistent obesity (OB-OB; (n = 74)), (b) obesity in the past but currently in a normal weight range (OB-NW; n = 156), (c) normal weight throughout the lifespan (NW-NW; n = 756), and (d) current obesity but previously at normal weight (NW-OB; n = 314). Lifetime obesity is associated with greater general psychopathology and personality traits such as low persistence and self-directedness, and high reward dependence. Additionally, greater extreme weight changes (NW-OB and OB-NW) were associated with higher psychopathology but not with greater ED severity. Higher dropout rates were found in the OB-OB group. These results shed new light on the BMI trajectory as a transdiagnostic feature playing a pivotal role in the severity and treatment outcome in patients with ED

Does ADHD Symptomatology Influence Treatment Outcome and Dropout Risk in Eating Disorders? A longitudinal Study

Attention-deficit/hyperactivity disorder (ADHD) and its symptoms have been shown to be present in patients with eating disorders (EDs) and are associated with increased psychopathology and more dysfunctional personality traits. This study aimed to assess if the presence of ADHD symptoms in patients with EDs affects their short and long-term therapy outcome. A total of 136 consecutively treated ED patients were considered in this study. Baseline pre-treatment evaluation included the Adult ADHD Self-Report Scale (ASRS v1.1) for ADHD symptoms and the assessment of eating symptomatology using the Eating Disorders Inventory (EDI-2). Treatment outcome was evaluated in terms of ED symptoms after cognitive behavioral therapy (CBT) and dropout rate during treatment. Furthermore, we evaluated ED symptoms in treatment completers after a follow-up of 8 years on average. Path analyses assessed the potential mediational role of the EDI-2 total score in the relationship between ADHD and treatment outcome. Results showed that baseline symptoms of ADHD indirectly affected treatment outcome after CBT; the ASRS positive screening was related to higher eating symptomatology (standardized coefficient B = 0.41, p = 0.001, 95% CI: 0.26 to 0.55), and the presence of high ED levels contributed to the increase of dropout (B = 0.15, p = 0.041, 95% CI: 0.03 to 0.33) and a worse treatment outcome (B = 0.18, p = 0.041, 95% CI: 0.01 to 0.35). No direct effect was found between the ASRS positive screening with the risk of dropout (B = −0.08, p = 0.375) and worse treatment outcome (B = −0.07, p = 0.414). These results suggest the relevance of identifying specific treatment approaches for patients with ADHD symptoms and severe eating symptomatolog

Nucleus accumbens functional connectivity and circulating endocannabinoids levels in anorexia nervosa

Introduction: Neuroimaging findings have reported aberrant functional connectivity in brain regions involved reward system in individuals with anorexia nervosa (AN) altering hedonic processing over food. Likewise, endocannabinoids such as Anandamide (AEA) and 2-Arachidonoylglycerol (2-AG) have been involved in rewarding aspects of food intake. Objectives: To identify nucleus accumbens (NAcc) functional connectivity with whole-brain comparing between individuals with AN and controls. Furthermore, in a sub-study, to explore the interaction between NAcc functional connectivity and peripheral AEA and 2-AG levels

Latent Classes for the Treatment Outcomes in Women with Gambling Disorder and Buying/Shopping Disorder

Background: The risk for behavioral addictions is rising among women within the general population and in clinical settings. However, few studies have assessed treatment effectiveness in females. The aim of this work was to explore latent empirical classes of women with gambling disorder (GD) and buying/shopping disorder (BSD) based on the treatment outcome, as well as to identify predictors of the different empirical groups considering the sociodemographic and clinical profiles at baseline. Method: A clinical sample of n = 318 women seeking treatment for GD (n = 221) or BSD (n = 97) participated. Age was between 21 to 77 years. Results: The four latent-classes solution was the optimal classification in the study. Latent class 1 (LT1, good progression to recovery) grouped patients with the best CBT outcomes (lowest risk of dropout and relapses), and it was characterized by the healthiest psychological state at baseline, the lowest scores in harm avoidance and self-transcendence, and the highest scores in reward dependence, persistence, self-directedness and cooperativeness. Latent classes 3 (LT3, bad progression to drop-out) and 4 (LT4, bad progression to relapse) grouped women with the youngest mean age, earliest onset of the addictive behaviors, and worst psychological functioning. Conclusions: GD and BSD are complex conditions with multiple interactive causes and impacts, which need wide and flexible treatment plans. Specific interventions should be designed according to the specific profiles of women for achieving early inclusion, retention and well-maintained long-term effects

Adaptación de las Metodologías de Evaluación Continua al Incremento del Número de Alumnos en el Aula

En el sistema de educación superior actual se siguen distintas metodologías de evaluación que comparten como elemento destacado el situar al alumno en el centro del proceso de aprendizaje, persiguiendo así que se garantice la adquisición por parte del alumno de las competencias específicas objeto de estudio. Esto ha supuesto en los últimos años un replanteamiento de la naturaleza y el diseño de todos los elementos estructurales de la enseñanza, pero este proceso de adaptación se ve de nuevo afectado por las actuales circunstancias, ya que nos encontramos con nuevos problemas, como son el tener que adaptar la metodología y el sistema de evaluación a un importante incremento de alumnos en el aula. Este es el caso de la asignatura de Cálculo Numérico II, del Grado de Matemáticas en la Universidad de Alicante, que ha pasado de 21 alumnos en el curso 2014-2015 a 39 alumnos en 2015-2016, manteniendo un único grupo de teoría y prácticas. En este trabajo se estudiará cómo se ha abordado este problema, en continuidad con estudios anteriores sobre la revisión de las metodologías de evaluación formativa de esta asignatura (Vigo et al, 2016a, 2016b). En particular, nos centraremos en la revisión de las estrategias implementadas como parte del sistema de evaluación, y en su adaptación a las circunstancias actuales y las dificultades que conllevan. El incremento de alumnos por aula ha forzado una adaptación de las técnicas de evaluación, y en este trabajo vamos a analizar y discutir los cambios realizados y los resultados subsecuentes