The Binge Eating Scale: Structural Equation Competitive Models, Invariance Measurement Between Sexes, and Relationships With Food Addiction, Impulsivity, Binge Drinking, and Body Mass Index

Introduction: The Binge Eating Scale (BES) is a widely used self-report questionnaire to identify compulsive eaters. However, research on the dimensions and psychometric properties of the BES is limited.Objective: The aim of this study was to examine the properties of the Spanish version of the BES.Methods: Confirmatory Factor Analyses (CFAs) were carried out to verify the BES factor structure in a sample of Spanish college students (N = 428, 75.7% women; age range = 18–30). An invariance measurement routine was carried out across sexes, the latent means were compared, and estimates of reliability and convergent and discriminant validity were presented.Results: A one-factor model fit the data best and was also equivalent between sexes. The scalar invariance model showed statistically significant differences across sexes, with a higher prevalence in women. Regarding reliability, the results were excellent. Finally, high statistically significant correlations were obtained with other measures of binge eating (BE), food addiction, impulsivity, binge drinking, and body mass index (BMI).Conclusion: The Spanish 16-item BES is a valid and reliable scale to evaluate BE in the youth population

Interventions for family members and carers of patients with borderline personality disorder: A systematic review

Carers of patients with borderline personality disorder (BPD) experience high levels of distress. Several studies have been carried out on interventions designed to decrease their burden. However, the evidence from these studies has not been summarized. The objective of this work is to explore the clinical utility of interventions developed for family members of patients with BPD. A systematic review was conducted following the PRISMA guidelines (registration number CRD42018107318), including psychological interventions focused on relatives of patients with BPD. The following databases were used: PsycINFO, PubMed, EBSCOhost, and Web of Science. Two independent researchers reviewed the studies to determine whether the eligibility criteria were met. A total of 2,303 abstracts were identified. After duplicates had been removed, 1,746 studies were screened. Finally, 433 full‐text articles were reviewed, yielding 11 studies that satisfied the inclusion criteria. Results show that these interventions with different clinical formats and settings are effective. The quality of the included studies varies, and the empirical support for these programs is still preliminary. The results help to establish a general framework for interventions specifically developed for family members of patients with BPD, but additional efforts should be made to improve the methodological quality of this field of research and more solidly determine the utility of these interventions. Given the paucity of data so far, this information may open up new lines of research to improve the effectiveness of future programs for carers of patients with BPD and help to reduce their burden

Too many lemons to make lemonade? Disentangling mental health during the third wave of COVID-19 infections in Spain

The study aimed to analyze the longitudinal change in mental health during the third wave of COVID-19 infections in Spain. Negative (e.g., emotional distress) and positive (e.g., positive functioning variables) outcomes were analyzed. Protective factors (e.g., resilience) as predictors of psychological adjustment (i.e., positive mental health, openness to the future, and low burden due to COVID-19) after ten months of the pandemic were also examined. The sample consisted of 164 participants, and self-reported questionnaires were administered at the beginning of the lockdown (March 2020), at the end of the lockdown (June 2020), and during the third wave (January 2021). Linear mixed models showed that individuals’ emotional distress increased, and positive functioning variables (i.e., meaning in life, gratitude, resilience, and life satisfaction) decreased over time, but an increase was observed in some dimensions of posttraumatic growth. Regression analyses showed that resilience scores at all three data collection time points were significant predictors of positive mental health, openness to the future, and burden during the third wave. Mediation analyses showed that positive mental health and openness to the future were mediators of the effect of resilience on burden. The prolonged situation of the COVID-19 crisis had an important impact on positive and negative mental health. However, resilience may help to build up resources that can act as a buffer against adverse psychological effects

How the COVID-19 pandemic and its consequences affect the presence of and search for meaning of life: a longitudinal study

The presence of meaning in life (PML) and the search for meaning in life (SML) are crucial when facing difficult times. Although several theoretical frameworks have tried to explain the dynamics of meaning in life during adversity, empirical evidence about interactions among both constructs using longitudinal designs is scarce. This study examined the trajectories of both PML and SML during the COVID-19 lockdown period in Spain. In total, 220 adults fulfilled an online survey during two periods: a strict and a relaxed lockdown period. Latent growth models showed that both PML and SML declined slightly during the strict lockdown, but they reached a plateau during the relaxed lockdown. Results also showed that age and having a partner predicted higher PML and lower SML at baseline, whereas being male predicted higher scores on PML. PML and SML were negatively associated at baseline, higher SML at baseline was related to a steeper decreasing PML slope during the strict lockdown, and the PML and SML slopes in the relaxed lockdown period were negatively related. This study contributes to better understanding longitudinal fluctuations of meaning in life in situations of adversity

Food addiction and its relationship with other eating behaviours among Spanish university students

BackgroundFood addiction (FA) is characterised by symptoms such as loss of control over food consumption, inability to reduce consumption despite the desire to do so, and continued consumption despite negative consequences. The modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) is a widely used instrument to assess FA.ObjectivesTo validate the Spanish mYFAS 2.0; to analyse the relationships between FA with other eating behaviours, sociodemographic variables, and Body Mass Index (BMI); and to test the eating-related variables that account for the variance in FA.MethodsThe sample consisted of 400 university students (M-age = 24.16, SDage = 6.12; 51% female), who completed the mYFAS 2.0 and measures of eating-related constructs.ResultsA confirmatory factor analysis (CFA) supported the one-factor structure of the mYFAS 2.0. The scale showed good internal consistency (alpha = .78), and good convergent validity with the mYFAS. FA was related to eating styles, binge eating, and bulimia. No differences in FA were observed between males and females, and there was no association between FA and BMI. In addition, younger participants scored higher on FA than older participants. The eating-related variables explain 54.7% of the variance in FA.ConclusionsThe mYFAS 2.0 is a valid and reliable scale to assess FA in the Spanish population. The positive and significant relationship of variables related to eating (eating styles, binge eating and bulimia) with FA was demonstrated. These variables were indicated by those at high risk of FA. Plain English summaryFood addiction (FA) is characterised by excessive and dysregulated intake of high-calorie foods. Loss of control over food consumption, inability to reduce consumption, and continued consumption despite negative consequences are some of its symptoms. The modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) is a brief instrument specifically developed to assess FA. The objectives of this study were: (1) to examine the psychometric properties of the Spanish mYFAS 2.0; (2) to analyse the relationships between FA with other eating behaviours, sociodemographic variables, and Body Mass Index (BMI); and (3) to test whether there are certain dietary variables that may be positively related to FA. We were able to provide evidence that the mYFAS 2.0 is a valid and reliable scale for assessing FA in the Spanish population. The positive and significant relationship of eating-related variables (eating styles, binge eating and bulimia) with FA was demonstrated. These variables can be considered to identify subgroups at high risk of FA

Indomethacin blocks the increased conditioned rewarding effects of cocaine induced by repeated social defeat

It is well established that repeated social defeat stress can induce negative long-term consequences such as increased anxiety-like behavior and enhances the reinforcing effect of psychostimulants in rodents. In the current study, we evaluated how the immune system may play a role in these long-term effects of stress. A total of 148 OF1 mice were divided into different experimental groups according to stress condition (exploration or social defeat) and pre-treatment (saline, 5 or 10 mg/kg of the anti-inflammatory indomethacin) before each social defeat or exploration episode. Three weeks after the last social defeat, anxiety was evaluated using an elevated plus maze paradigm. After this test, conditioned place preference (CPP) was induced by a subthreshold dose of cocaine (1 mg/kg). Biological samples were taken four hours after the first and the fourth social defeat, 3 weeks after the last defeat episode, and after the CPP procedure. Plasma and brain tissue (prefrontal cortex, striatum and hippocampus) were used to determine the levels of the pro-inflammatory cytokine interleukin 6 (IL-6). Results showed an increase of peripheral and brain IL-6 levels after the first and fourth social defeat that was reverted three weeks later. Intraperitoneal administration of the anti-inflammatory drug indomethacin before each episode of stress prevented this enhancement of IL-6 levels and also reversed the increase in the rewarding effects of cocaine in defeated mice. Conversely, this protective effect was not observed with respect to the anxiogenic consequences of social stress. Our results confirm the hypothesis of a modulatory proinflammatory contribution to stress-induced vulnerability to drug abuse disorders and highlight anti-inflammatory interventions as a potential therapeutic tool to treat stress-related addiction disorders

“Own doctor” presence in a web-based lifestyle intervention for adults with obesity and hypertension: A randomized controlled trial

Introduction: Online interventions have long been shown to be an effective means to promote a healthy lifestyle, thereby helping to control body weight and blood pressure figures. Likewise, using video modeling is also considered an effective way to guide patients through behavioral interventions. Nonetheless, to the best of our knowledge, this study is the first to analyze how the presence of patients' “own doctor” in the audiovisual content of a web-based lifestyle program (“Living Better”) aimed at promoting regular physical exercise and healthy eating behavior, compared with an “unknown doctor,” influences the outcomes of adults with obesity and hypertension. Materials and methods: A total of 132 patients were randomly assigned either to the experimental (n = 70) or control (n = 62) group (“own doctor” or “unknown doctor”, respectively). The body mass index, systolic and diastolic blood pressure, number of antihypertensive drugs used, physical activity level, and quality of life was assessed and compared at baseline and post-intervention (12 weeks).Results: The intention-to-treat analysis showed intragroup significant improvements in both groups in terms of the body mass index (control group: mean difference −0.3, 95% CI [−0.5, −0.1], p = 0.002; experimental group: −0.4 [−0.6, −0.2], p < 0.001) and systolic blood pressure (control group: −2.3 [−4.4, −0.2], p = 0.029; experimental group: −3.6 [−5.5, −1.6], p< 0.001). In addition, there were also significant improvements in the experimental group for the diastolic blood pressure (−2.5 [−3.7, −1.2], p < 0.001), physical activity (479 [9, 949], p = 0.046), and quality of life (5.2 [2.3, 8.2], p = 0.001). However, when comparing the experimental with the control group, no between-group significant differences were found in these variables.Conclusions: This study suggests that the presence of patients' “own doctor” in the audiovisual content of a web-based intervention, aimed at promoting a healthy lifestyle among adults with obesity and hypertension, do not show significant additional benefits over the efficacy of e–counseling.Trial registrationClinicalTrials.gov NCT04426877. First Posted: 11/06/2020. https://clinicaltrials.gov/ct2/show/NCT04426877

mHealth intervention to improve quality of life in patients with chronic diseases during the COVID-19 crisis in Paraguay: A study protocol for a randomized controlled trial

Background Patients with chronic disease represent an at-risk group in the face of the COVID-19 crisis as they need to regularly monitor their lifestyle and emotional management. Coping with the illness becomes a challenge due to supply problems and lack of access to health care facilities. It is expected these limitations, along with lockdown and social distancing measures, have affected the routine disease management of these patients, being more pronounced in low- and middle-income countries with a flawed health care system. Objectives The purpose of this study is to describe a protocol for a randomized controlled trial to test the efficacy of the Adhera® MejoraCare Digital Program, an mHealth intervention aimed at improving the quality of life of patients with chronic diseases during the COVID-19 outbreak in Paraguay. Method A two-arm randomized controlled trial will be carried out, with repeated measures (baseline, 1-month, 3-month, 6-month, and 12-month) under two conditions: Adhera® MejoraCare Digital Program or waiting list. The primary outcome is a change in the quality of life on the EuroQol 5-Dimensions 3-Levels Questionnaire (EQ-5D-3L). Other secondary outcomes, as the effect on anxiety and health empowerment, will be considered. All participants must be 18 years of age or older and meet the criteria for chronic disease. A total of 96 participants will be recruited (48 per arm). Conclusions It is expected that the Adhera® MejoraCare Digital Program will show significant improvements in quality of life and emotional distress compared to the waiting list condition. Additionally, it is hypothesized that this intervention will be positively evaluated by the participants in terms of usability and satisfaction. The findings will provide new insights into the viability and efficacy of mHealth solutions for chronic disease management in developing countries and in times of pandemic

Relationship between dysfunctional eating patterns and binge drinking in young people and associated risk factors

La joventut (compresa entre els 18 i 30 anys) es considera un període de vulnerabilitat, en què és freqüent observar trastorns alimentaris, consum de drogues i una major tendència a buscar noves sensacions i comportaments de risc, entre moltes altres conductes. En concret, hi ha dos comportaments molt prevalents en els joves i s'associen amb conseqüències de salut molt negatives: el consum de menjar ultraprocessat i el consum d'alcohol. Tot i això, el problema no rau només en el tipus de consum (és a dir, beure alcohol o menjar menjar ràpid), sinó també en com es consumeix l'alcohol o el menjar. L'afartament es caracteritza per la ingesta de grans quantitats de menjar (afartament de menjar) o d'alcohol (afartament d'alcohol) de forma incontrolada i en un curt període de temps. Tots dos problemes solen presentar-se de forma comòrbida i s'associen amb conseqüències de salut molt greus als joves. L'addicció al menjar, entesa com la ingesta excessiva i desregulada d'aliments amb alt contingut en greixos i/o sucres, és també molt prevalent en els joves i també té un impacte molt negatiu en la salut i el benestar. Donada l'elevada prevalença d'aquestes conductes en els joves i les conseqüències associades, així com la seua elevada comorbilitat reportada, calen estudis que analitzen la relació entre aquestes conductes i els factors de risc que hi poden estar associats, per tal de dissenyar programes de prevenció i tractament adequats. Per això, l'objectiu principal d'aquesta Tesi Doctoral és estudiar la relació entre els patrons alimentaris disfuncionals (ingesta de greix, afartament de menjar, estils d'ingesta i addicció al menjar) i els afartaments d'alcohol en joves, i examinar els factors de risc associats a aquestes conductes. Els objectius específics són: 1) Revisar la literatura per identificar els punts en comú entre els afartaments de menjar i els afartaments d'alcohol, les diferències i la influència que exerceix un sobre un altre i viceversa. 2) Validar la Binge Eating Scale per mesurar els afartaments de menjar en població jove espanyola. 3) Analitzar el paper predictiu dels patrons alimentaris disfuncionals en els afartaments d'alcohol en joves. 4) Analitzar si els patrons alimentaris disfuncionals (concretament afartaments de menjar i ingesta de greixos) medien la relació entre diversos factors individuals (gènere; índex de massa corporal; impuls de primesa; insatisfacció corporal; estils d'ingesta: emocional, extern i restrictiu; impulsivitat i addicció al menjar) i els afartaments d’alcohol en joves. 5) Validar la modified Yale Food Addiction Scale 2.0 per mesurar l'addicció al menjar en població espanyola. 6) Analitzar el poder predictiu de l'índex de massa corporal, els estils d'ingesta (menjar emocional, extern i restrictiu), els afartaments de menjar i la bulímia sobre l'addicció al menjar en joves. 7) Analitzar les diferències en els estils d'ingesta (menjar emocional, extern i restrictiu), els patrons alimentaris disfuncionals (afartaments de menjar i ingesta de greixos) i l'índex de massa corporal abans i durant el confinament per COVID-19 en joves. 8) Analitzar el poder predictiu dels estils d'ingesta (menjar emocional, extern i restrictiu) sobre els patrons alimentaris disfuncionals (afartaments de menjar i ingesta de greixos) i l'índex de massa corporal durant el confinament per COVID-19 a joves. 9) Avaluar si els estils d'ingesta (menjar emocional, extern i restrictiu) moderen la relació entre l'estrès percebut i els afartaments de menjar durant el confinament per COVID-19 en joves. Les principals troballes dels estudis demostren que les conductes alimentàries disfuncionals (com els afartaments de menjar, la ingesta de greixos, els estils d'ingesta i l'addicció al menjar) poden actuar com a factors de risc dels afartaments de beguda. Per la seua banda, l'índex de massa corporal, els estils d'ingesta, els afartaments de menjar i la bulímia poden actuar com a factors de risc de l'addicció al menjar. Finalment, els estils d'ingesta juguen un paper predictiu important en els afartaments de menjar, la ingesta de greixos i l'índex de massa corporal durant el confinament per COVID-19. Per tant, considerant aquests resultats podem assenyalar que la detecció de perfils de vulnerabilitat ens pot ajudar a prevenir i tractar aquestes conductes en els joves i evitar-ne les conseqüències associades.Youth (between 18 and 30 years of age) is considered a period of vulnerability, in which eating disorders, drug use and a greater tendency to seek new sensations and risky behaviors, among many other behaviors, are frequently observed. In particular, there are two behaviors that are very prevalent in young people and are associated with very negative health consequences: the consumption of ultra-processed food and alcohol consumption. However, the problem lies not only in the type of consumption (i.e., drinking alcohol or eating fast food), but also in how the alcohol or food is consumed. Binge eating is characterized by the ingestion of large amounts of food (binge eating) or alcohol (binge drinking) in an uncontrolled manner and in a short period of time. Both problems often occur comorbidly and are associated with very serious health consequences in young people. Food addiction, understood as the excessive and deregulated intake of foods high in fat and/or sugars, is also very prevalent in young people and also has a very negative impact on their health and well-being. Given the high prevalence of these behaviors in young people and the associated consequences, as well as their high reported comorbidity, studies are needed to analyze the relationship between these behaviors and the risk factors that may be associated with them, in order to design appropriate prevention and treatment programs. Therefore, the main objective of this Doctoral Thesis is to study the relationship between dysfunctional eating patterns (fat intake, binge eating, eating styles and food addiction) and binge drinking in young people, and to examine the risk factors associated with these behaviors. The specific objectives are: 1) To review the literature to identify commonalities between binge eating and binge drinking, differences, and the influence exerted by one on the other and vice versa. 2) To validate the Binge Eating Scale to measure binge eating in a young Spanish population. 3) To analyze the predictive role of dysfunctional eating patterns on binge drinking in young people. 4) To analyze whether dysfunctional eating patterns (specifically binge eating and fat intake) mediate the relationship between various individual factors (gender; body mass index; drive for thinness; body dissatisfaction; emotional, external and restrictive eating styles; impulsivity and food addiction) and binge drinking in young people. 5) To validate the modified Yale Food Addiction Scale 2.0 to measure food addiction in Spanish population. 6) To analyze the predictive power of body mass index, eating styles (emotional, external and restrictive eating), binge eating and bulimia on food addiction in young people. 7) To analyze differences in eating styles (emotional, external and restrictive eating), dysfunctional eating patterns (binge eating and fat intake) and body mass index before and during COVID-19 confinement in youth. 8) To analyze the predictive power of eating styles (emotional, external and restrictive eating) on dysfunctional eating patterns (binge eating and fat intake) and body mass index during COVID-19 confinement in youth. 9) To assess whether eating styles (emotional, external, and restrictive eating) moderate the relationship between perceived stress and binge eating during COVID-19 confinement in youth. The main findings of the studies demonstrate that dysfunctional eating behaviors (such as binge eating, fat intake, eating styles, and food addiction) may act as risk factors for binge drinking. For their part, body mass index, eating styles, binge eating and bulimia may act as risk factors for food addiction. Finally, eating styles play an important predictive role in binge eating, fat intake and body mass index during COVID-19 confinement. Therefore, considering these results we can point out that the detection of vulnerability profiles can help us to prevent and treat these behaviors in young people and avoid their associated consequences

Eating behaviors, eating styles and body mass index during COVID-19 confinement in a college sample: a predictive model

Plain English summary The COVID-19 confinement affected the lifestyles of the young population, especially eating behaviors. It is not yet known whether eating problems, such as binge eating and high fat intake, changed during this period in the young people. It is also not known whether the young population perceived changes in their BMI during COVID-19 confinement. In addition, eating styles (emotional eating, restrictive eating, and external eating) may be predictors of this change. The present study found that binge eating and fat intake decreased in COVID-19 confinement, and BMI and eating styles remained stable. Eating styles predicted change in these eating problems (binge eating and fat intake) and change in BMI during this period of elevated stress. Therefore, eating styles may help to understand dietary changes during times of high stress