Emotion regulation in binge eating disorder: a review

FSW - Self-regulation models for health behavior and psychopathology - ou

Problematic eating behaviours of autistic women: A scoping review

Aim: Eating and feeding behaviours of autistic individuals and related consequences have been mainly investigated in autistic children or in autistic adults with intellectual disabilities. Behaviours such as food selectivity or food neophobia have been shown to persist into adolescence and adulthood and are associated with aversive consequences. However, much less is known about the eating behaviours of autistic adults without intellectual disabilities, especially those of women. By means of a scoping review, we aim to assess the extent of the scientific literature on what is known about the eating behaviours of these women and the possible consequences of such eating behaviour. Method: Medline, Cochrane, PubMed and PsycInfo databases were searched according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Results: Five studies met the eligibility criteria and were included in this review. Autistic women not only reported high levels of eating behaviour frequently seen in autism spectrum disorders (ASD), but also high levels of disordered eating behaviour, similar to that of women with eating disorders. Conclusions: Autistic women seem to exhibit high levels of eating behaviour frequently seen in ASD as well as disordered eating behaviour. Future research needs to shed light on what underlies these problematic eating behaviours, in order to help to adapt current treatment modalities to meet the unique needs of these women

Cognitive and Experienced Flexibility in Patients With Anorexia Nervosa and Obsessive Compulsive Disorder

Objective: Anorexia nervosa (AN) and obsessive-compulsive disorder (OCD) share a neuropsychological profile characterized by cognitive inflexibility as evident in set-shifting problems, and by strong detail focus. Clinically, both patient groups display a strong rigidity which may be explained by these neurocognitive difficulties. Cognitive inflexibility may hinder treatment uptake and help explain suboptimal treatment outcomes in both AN and OCD. This is the first study to compare clinical AN and OCD groups and to examine similarities and differences in cognitive flexibility. Specifically, this study aims to investigate neuropsychological outcomes and self-reported difficulties in both clinical groups and a control group, and explore associations between the different flexibility outcomes and illness. Method: Two hundred participants (61 AN, 72 OCD and 67 HC) performed neuropsychological tasks on set-shifting abilities (Trail Making Task, Stroop color-word interference, Intradimensional-Extradimensional shift task), detail focus (Group Embedded Figures Test) and self-reported set-shifting abilities and attention to detail (DFlex). Results: Similarities between patient groups were found in terms of reduced set-shifting ability on the Trail Making Task and detail focus. Moreover, both patient groups self-reported more set-shifting problems but a less strong detail focus than HC, which in turn were not related to neuropsychological task outcomes in either of the groups. In both patient groups longer illness duration was associated to longer reaction times in the switching tasks and for both groups symptom severity was associated to higher experienced inflexibility and attention to detail. Conclusion: Cognitive inflexibility processes are largely similar in patients with AN and OCD. Both patient groups report inflexibility, yet this is unrelated to neuropsychological outcomes. Illness duration seems to contribute to poorer set-shifting and higher illness severity is linked to more experienced inflexibility. Findings highlight the need for entangling different domains of cognitive flexibility and detail focus and examining self-report measures for a cohesive understanding of clinically relevant flexibility weaknesses in AN and OCD

The effects of polyunsaturated fatty acid (PUFA) administration on the microbiome-gut-brain axis in adolescents with anorexia nervosa (the MiGBAN study): study protocol for a longitudinal, double-blind, randomized, placebo-controlled trial

Background Anorexia nervosa (AN) is a severe psychiatric disease that often takes a chronic course due to insufficient treatment options. Emerging evidence on the gut-brain axis offers the opportunity to find innovative treatments for patients with psychiatric disorders. The gut microbiome of patients with AN shows profound alterations that do not completely disappear after weight rehabilitation. In previous studies, the administration of polyunsaturated fatty acids (PUFA) resulted in effects that might be beneficial in the treatment of AN, affecting the microbiome, body weight and executive functions. Therefore, the MiGBAN study aims to examine the effects of a nutritional supplementation with PUFA on the gut microbiome and body mass index (BMI) in patients with AN. Methods This is a longitudinal, double-blind, randomized, placebo-controlled trial. Within 2 years, 60 adolescent patients aged 12 to 19 years with AN will receive either PUFA or placebo for 6 months additional to treatment as usual. After 1 year, the long-term effect of PUFA on the gut microbiome and consecutively on BMI will be determined. Secondary outcomes include improvement of gastrointestinal symptoms, eating disorder psychopathology, and comorbidities. Additionally, the interaction of the gut microbiome with the brain (microbiome-gut-brain axis) will be studied by conducting MRI measurements to assess functional and morphological changes and neuropsychological assessments to describe cognitive functioning. Anti-inflammatory effects of PUFA in AN will be examined via serum inflammation and gut permeability markers. Our hypothesis is that PUFA administration will have positive effects on the gut microbiota and thus the treatment of AN by leading to a faster weight gain and a reduction of gastrointestinal problems and eating disorder psychopathology. Discussion Due to previously heterogeneous results, a systematic and longitudinal investigation of the microbiome-gut-brain axis in AN is essential. The current trial aims to further analyse this promising research field to identify new, effective therapeutic tools that could help improve the treatment and quality of life of patients. If this trial is successful and PUFA supplementation contributes to beneficial microbiome changes and a better treatment outcome, their administration would be a readily applicable additional component of multimodal AN treatment

The effects of probiotics administration on the gut microbiome in adolescents with anorexia nervosa—A study protocol for a longitudinal, double-blind, randomized, placebo-controlled trial

Objective Knowledge on gut?brain interaction might help to develop new therapies for patients with anorexia nervosa (AN), as severe starvation-induced changes of the microbiome (MI) do not normalise with weight gain. We examine the effects of probiotics supplementation on the gut MI in patients with AN. Method This is a study protocol for a two-centre double-blind randomized-controlled trial comparing the clinical efficacy of multistrain probiotic administration in addition to treatment-as-usual compared to placebo in 60 patients with AN (13?19 years). Moreover, 60 sex- and age-matched healthy controls are included in order to record development-related changes. Assessments are conducted at baseline, discharge, 6 and 12 months after baseline. Assessments include measures of body mass index, psychopathology (including eating-disorder-related psychopathology, depression and anxiety), neuropsychological measures, serum and stool analyses. We hypothesise that probiotic administration will have positive effects on the gut microbiota and the treatment of AN by improvement of weight gain, gastrointestinal complaints and psychopathology, and reduction of inflammatory processes compared to placebo. Conclusions If probiotics could help to normalise the MI composition, reduce inflammation and gastrointestinal discomfort and increase body weight, its administration would be a readily applicable additional component of multi-modal AN treatment

The effects of polyunsaturated fatty acid (PUFA) administration on the microbiome-gut-brain axis in adolescents with anorexia nervosa (the MiGBAN study): study protocol for a longitudinal, double-blind, randomized, placebo-controlled trial

Background: Anorexia nervosa (AN) is a severe psychiatric disease that often takes a chronic course due to insufficient treatment options. Emerging evidence on the gut-brain axis offers the opportunity to find innovative treatments for patients with psychiatric disorders. The gut microbiome of patients with AN shows profound alterations that do not completely disappear after weight rehabilitation. In previous studies, the administration of polyunsaturated fatty acids (PUFA) resulted in effects that might be beneficial in the treatment of AN, affecting the microbiome, body weight and executive functions. Therefore, the MiGBAN study aims to examine the effects of a nutritional supplementation with PUFA on the gut microbiome and body mass index (BMI) in patients with AN. Methods: This is a longitudinal, double-blind, randomized, placebo-controlled trial. Within 2 years, 60 adolescent patients aged 12 to 19 years with AN will receive either PUFA or placebo for 6 months additional to treatment as usual. After 1 year, the long-term effect of PUFA on the gut microbiome and consecutively on BMI will be determined. Secondary outcomes include improvement of gastrointestinal symptoms, eating disorder psychopathology, and comorbidities. Additionally, the interaction of the gut microbiome with the brain (microbiome-gut-brain axis) will be studied by conducting MRI measurements to assess functional and morphological changes and neuropsychological assessments to describe cognitive functioning. Anti-inflammatory effects of PUFA in AN will be examined via serum inflammation and gut permeability markers. Our hypothesis is that PUFA administration will have positive effects on the gut microbiota and thus the treatment of AN by leading to a faster weight gain and a reduction of gastrointestinal problems and eating disorder psychopathology. Discussion: Due to previously heterogeneous results, a systematic and longitudinal investigation of the microbiome-gut-brain axis in AN is essential. The current trial aims to further analyse this promising research field to identify new, effective therapeutic tools that could help improve the treatment and quality of life of patients. If this trial is successful and PUFA supplementation contributes to beneficial microbiome changes and a better treatment outcome, their administration would be a readily applicable additional component of multimodal AN treatment. Trial registration: German Clinical Trials Register DRKS00017130. Registered on 12 November 2019

Analysis of shared heritability in common disorders of the brain

Paroxysmal Cerebral Disorder

By force of habit: On the formation and maintenance of goal-directed habits

The aim of this thesis was to examine how goal-directed habits are formed and established. Specifically, the focus was on the cognitive mechanism underlying habits and the role of habits in guiding goal-directed behavior. In daily life we perform all kinds of behaviors to attain specific goals in absence of conscious awareness. People are able to perform rather complex behaviors (e.g., getting to work, socializing with friends) in the absence of explicit intent as a result of frequently engaging in them. In Chapter two, three studies examined the cognitive processes underlying the formation of goal-directed habits in a multiple means context. Habits are formed through the repeated retrieval and selection of a specific means for goal attainment. Repeated retrieval of target means upon goal activation was expected to result in inhibition of competing means for the same goal to prevent these latter means from interfering. In all studies, participants studied goal-means combinations and subsequently practiced the retrieval of certain means to attain the goals in a retrieval-paradigm. It was found that competing means were inhibited after repeated retrieval of the target means. Furthermore, it was demonstrated that inhibition occurred in the absence of explicit intent or instructions to suppress the competing means. In Chapter three, two studies examined whether the formation of intentions to pursue a goal in a non-habitual manner causes inhibited access to habitual means to attain that goal. An idiosyncratic approach was used to assess personalized goal-means relations. The results indicated that the formation of an intention to use non-habitual means inhibited the representations of the habitual means in order to prevent habitual intrusion. However, the intention to use habitual means did not cause inhibited access to non-habitual means. In Chapter four, the role of habit and intention in the prediction of future behavior was examined by analyzing that past behavior frequency moderates the intention-behavior relationship to the extent that the context in which the behavior was performed is stable. In two correlational studies it was found that intentions guided future behavior when habits were weak (low frequency or unstable context), while this was not the case when habits were strong (high frequency and stable context). A third exploratory study suggested that, if habitual goal-directed behavior is automatically activated by the context, mental accessibility of the behavior moderates the intention-behavior relation in a similar way. To summarize, the research in this thesis emphasizes the importance of two factors underlying habits that so far have almost not been considered: the influence of inhibitory processes and the role of context stability. The implications of these findings as well as the possible ways to influence habits and the possible difficulties are discussed in the final chapter of this thesis

Habit formation and multiple means to goal attainment: Repeated retrieval of target means causes inhibited access to competitors

Three studies examined the cognitive processes underlying the formation of goal-directed habits in a multiple means context. Repeated retrieval of target means upon goal activation was expected to result in inhibition of competing means for the same goal. In all studies, participants studied goal-means combinations and subsequently practiced the retrieval of certain means to attain the goals in a retrieval paradigm. Study 1 tested accessibility of the different means in a goal-means verification task and showed that competing means were not inhibited after a single retrieval but only upon repeated retrieval (three or nine times). Studies 2 and 3 extended these findings in a means-recognition task and demonstrated that inhibition occurred in the absence of explicit intent or instructions to suppress the competitors. These inhibitory effects of competing means are discussed against the background of current social cognition research on the processes underlying goal-means networks and the formation of habits

Habit vs. intention in the prediction of future behaviour: the role of frequency, context stability and mental accessibility of past behaviour.

This research examined the role of habit and intention in the prediction of future behaviour by analysing that past behaviour frequency moderates the intention-behaviour relationship to the extent that the context in which the behaviour was performed is stable. In two correlational studies, it was found that habit interacted with intention when context stability was taken into account and not when merely past behaviour frequency was considered: intentions guided future behaviour when habits were weak (low frequency or unstable context), while this was not the case when habits were strong (high frequency and stable context). A third exploratory study investigated and confirmed the idea that, if habitual goal-directed behaviour is directly activated by the context, mental accessibility of the behaviour (i.e. the ease of accessing the goal-directed behaviour in memory) moderates the intention-behaviour relation in a similar way. These findings are discussed against the background of current research on goal-directed habits and the cognitive processes underlying the