The role of sexual orientation in the relationships between body perception, body weight dissatisfaction, physical comparison, and eating psychopathology in the cisgender population

Purpose: Body weight dissatisfaction (BWD) and visual body perception are specific aspects that can influence the own body image, and that can concur with the development or the maintenance of specific psychopathological dimensions of different psychiatric disorders. The sexual orientation is a fundamental but understudied aspect in this field, and, for this reason, the purpose of this study is to improve knowledge about the relationships among BWD, visual body size-perception, and sexual orientation. Methods: A total of 1033 individuals participated in an online survey. Physical comparison, depression, and self-esteem was evaluated, as well as sexual orientation and the presence of an eating disorder. A Figure Rating Scale was used to assess different valences of body weight, and mediation analyses were performed to investigated specific relationships between psychological aspects. Results: Bisexual women and gay men reported significantly higher BWD than other groups (p < 0.001); instead, higher body misperception was present in gay men (p = 0.001). Physical appearance comparison mediated the effect of sexual orientation in both BWD and perceptual distortion. No difference emerged between women with a history of eating disorders and without, as regards the value of body weight attributed to attractiveness, health, and presence on social media. Conclusion: This study contributes to understanding the relationship between sexual orientations and body image representation and evaluation. Physical appearance comparisons should be considered as critical psychological factors that can improve and affect well-being. The impact on subjects with high levels of eating concerns is also discussed. Level of evidence: Level III: case\u2013control analytic study

Health-related quality of life assessment in eating disorders: adjustment and validation of a specific scale with the inclusion of an interpersonal domain

Purpose: Quality of life is a fundamental aspect of both clinical practice and research on eating disorders (ED) due to the significant impacts these disorders have on everyday life. Disorder-specific scales can improve the quality of research and findings and offer greater sensitivity and responsiveness. However, no specific instrument is available in Italian for ED. The aim of this paper is to adjust and to validate a reliable scale with specific items regarding physical and interpersonal well-being. Methods: The Italian version of the Eating Disorder Quality of Life (IEDQOL) scale was developed, on the basis of the original English scale, with the addition of items pertaining to physical well-being and interpersonal interactions. In this study, 180 ED patients and 190 healthy controls from the community were enrolled both from inpatient units and outpatient services. A statistical analysis with an exploratory factorial approach was performed in order to validate the tool. Results: The results showed that the IEDQOL has very good psychometric properties with test–retest validity and sensitivity between patients and controls (d = 2.17 for total score). Moreover, the interpersonal domain showed excellent psychometric values (Cronbach’s α &gt; 0.70 in all the subgroups) and a robust correlation with other quality of life constructs. Conclusion: Future studies on the Italian population should use IEDQOL as outcome element that can be useful also with other disorder-specific psychopathological constructs and corroborate the reliability of the data. Future research in the ED field should only use this specific tool. Level of evidence: Case–control analytic study, Level III

Addressing Weight Bias in the Cisgender Population: Differences between Sexual Orientations

(1) Background: Weight bias (WB) is an implicit psychological construct that can influence attitudes, beliefs, body experience, and evaluation of specific psychopathology relationships. Sexual orientation has played a crucial role in developing and maintaining psychiatric conditions linked to body evaluation, but few studies have evaluated possible connected biases. Thus, the paper aims to assess potential relationships between sexual orientation and WB, looking at potential roles in specific psychopathology; (2) Methods: A total of 836 cisgender subjects participated in an online survey, aged between 18 and 42 years old. Two specific aspects of WB were evaluated with validated scales about beliefs about obese people and fat phobia. Demographic variables, as well as depression and eating concerns were evaluated; (3) Results: Gay men and bisexual women showed higher levels of fat phobia, depression, and eating concerns. Regression analysis showed that sexual orientation significantly predicted fat phobia (p < 0.001) and beliefs about obese people (p = 0.014); (4) Conclusions: This study confirms the vulnerability of gay men and bisexual women to cognitive bias about their own bodies, showing a potential vulnerability about body and weight concerns

A multi-faceted evaluation of impulsivity traits and early maladaptive schemas in patients with anorexia nervosa

(1) Background: patients with Anorexia Nervosa (AN) are classified either as restrictive (ANr) or binge/purge (ANbp) according to the absence or presence of impulsive eating and com-pensatory behaviors. The aim of the present study was to assess the levels of impulsivity in both AN subtypes and to explore whether individual differences in impulsivity may be explained by differences in the presence of early maladaptive schemas. (2) Methods: the sample group included 122 patients with ANr, 112 patients with ANbp, and 131 healthy women (HW). All of these partici-pants completed the UPPS-P scale for an assessment of impulsive behaviors and the Young Schema Questionnaire (YSQ-S3) for an assessment of early maladaptive schemas. (3) Results: the patients with ANbp displayed higher levels of impulsivity compared with the patients with ANr and HW. Patients with AN, especially the restrictive subtype, also reported higher levels of early maladaptive schemas than HW, and regression analyses revealed that specific maladaptive schemas partially explain the variability in impulsivity in both patients and HW. (4) Conclusions: it appears that maladaptive beliefs developed during childhood or adolescence may predict the development of impulsivity, a personality trait usually associated with maladaptive behaviors, and appears to be prevalent among ANbp patients. The clinical effects of this, as well as directions for future study, are also discussed in this paper

Visuospatial Abilities in Eating Disorders

A consistent body of research reports reduced ability in visuospatial processing in the eating disorder population. It has been hypothesized that this neurocognitive alteration may be a consequence of the eating disorder per se or an underlying trait-marker. Visuospatial difficulties, in particular weak central coherence (a bias towards detail-focusing thinking style), along with executive dysfunctions, have been proposed as endophenotypic traits for anorexia nervosa individuals. In particular, anorexia nervosa patients and their unaffected relatives show a specific detail-focused information processing bias along with a central coherence weakness, with limited ability to gain and integrate contextual information. In bulimia nervosa individuals’ visuospatial profile appears less compromised, and, if a dysfunction is present, it seems to characterize specifically bulimia nervosa individuals with a prior history of anorexia nervosa. Visuospatial abilities should be detected and addressed in specific treatment programs due to their potentially negative role in both treatment outcome and body image disturbance, which typically affect individuals on the whole eating disorders spectrum

The predictive value of the early maladaptive schemas in social situations in anorexia nervosa

Background: Patients with anorexia nervosa (AN) show an impairment in the recognition and expression of emotions, as well as an increased sensitivity to being socially excluded, and rigid maladaptive schemas. The Cyberball paradigm is a virtual ball-toss game that can simulate social exclusion and inclusion. Our aim is to evaluate how cognitive schemas can influence the perception and the evaluation of the experiences of social inclusion/exclusion. Methods: Thirty-two AN patients and 34 healthy controls completed a psychological evaluation and were randomly assigned to exclusion or overinclusion paradigm of the Cyberball task. Results: Patients with AN showed a significantly higher level of maladaptive schemas as well as higher sensitivity to being ostracized by peers in comparison with healthy controls. Regression analyses identified specific significant relation between being ostracized and dependence/incompetence, negativity/pessimism, and self-sacrifice. Discussion: Our findings provide evidence that patients with AN may be ineffective in expressing their mood in exclusive and overinclusive social situations. Specific cognitive/temperamental schemas might play a role in the way people communicate their feelings, and they could be considered targets for psychotherapy interventions to improve social interpretation and emotional recognition/communication

Small-world properties of brain morphological characteristics in Anorexia Nervosa

Cortical thickness and gyrification abnormalities in anorexia nervosa (AN) have been recently described, but no attempt has been made to explore their organizational patterns to characterize the neurobiology of the disorder in the different stages of its course. The aim of this study was to explore cortical thickness and gyrification patterns by means of graph theory tools in 38 patients with AN, 20 fully recovered patients, and 38 healthy women (HC). All participants underwent high-resolution magnetic resonance imaging. Connectome properties were compared between: 1) AN patients and HC, 2) fully recovered patients and HC, 3) patients with a full remission at a 3-year follow-up assessment and patients who had not recovered. Small-worldness was greater in patients with acute AN in comparison to HC in both cortical thickness and gyrification networks. In the cortical thickness network, patients with AN also showed increased Local Efficiency, Modularity and Clustering coefficients, whereas integration measures were lower in the same group. Patients with a poor outcome showed higher segregation measures and lower small-worldness in the gyrification network, but no differences emerged for the cortical thickness network. For both cortical thickness and gyrification patterns, regional analyses revealed differences between patients with different outcomes. Different patterns between cortical thickness and gyrification networks are probably due to their peculiar developmental trajectories and sensitivity to environmental influences. The role of gyrification network alterations in predicting the outcome suggests a role of early maturational processes in the prognosis of AN

The Eating Disorder Quality of Life (EDQoL) Scale 72: Methods and Applications

Patients with an eating disorder present a severe reduction of their quality of life (QoL) during the acute phase, which could also impact their treatment outcome. Different studies have pointed out the role of QoL in both physical and psychological well-being, and slight differences have been pointed out between eating disorder diagnoses, showing a transdiagnostic impairment in this specific aspect of patients’ lives. Different domains have been included in the evaluation of the QoL: psychological, physical, cognitive, financial, work/school, and interpersonal. The relevance of the interpersonal domain is profoundly discussed in the chapter and how it has been included in the original version of the EDQoL questionnaire. Despite the role of this aspect in the patients’ lives, the literature’s evidence is limited, and possible future directions are discussed

Volume and complexity of the thalamus in Anorexia Nervosa: An exploratory evaluation

Objective: Recent neuroscientific findings have highlighted the role of the thalamus in several cognitive functions, ranging from perception to cognitive flexibility, memory, and body representation. Since some of these functions may be involved in the pathophysiology of Anorexia Nervosa (AN), this study aims at exploring thalamic structure in different phases of the disorder. Method: The sample included 38 patients with acute AN, 20 patients who fully recovered from AN (recAN), and 38 healthy controls (HC), all female. All participants underwent high-resolution MRI. The volumes of the whole thalamus and 25 thalamic nuclei were extracted using an automated segmentation algorithm, and thalamic fractal dimension was estimated using the calcFD toolbox. Results: Patients with acute AN, compared to HC, displayed reduced thalamic volume and complexity both at the whole level and at the level of specific nuclei. In patients recAN, instead, alterations were observed only at the level of the right laterodorsal and central lateral nuclei. Conclusions: In the acute phase of the disorder patients with AN present a widespread reduction in thalamic volume and complexity. However, these alterations seem to normalise almost completely following weight restoration, thus suggesting the involvement of malnutrition-related mechanisms