The compulsive exercise test: confirmatory factor analysis and links with eating psychopathology among women with clinical eating disorders

Background: This study aimed to determine the psychometric properties of the Compulsive Exercise Test (CET) among an adult sample of patients with eating disorders. Method: Three hundred and fifty six patients and 360 non-clinical control women completed the CET and the Eating Disorders Examination questionnaire (EDE-Q). Results: A confirmatory factor analysis revealed that the clinical data showed a moderate fit to the previously published five factor model derived from a community sample (Taranis L, Touyz S, Meyer C, Eur Eat Disord Rev 19: 256-268, 2011). The clinical group scored significantly higher than the non-clinical group on four of the five CET subscales, and logistic regression analysis revealed that the CET could successfully discriminate between the two groups. A Receiver Operating Curve analysis revealed that a cut-off score of 15 on the CET resulted in acceptable values of both sensitivity and specificity. Conclusions: The CET appears to have a factor structure that is acceptable for use with an adult sample of patients with eating disorders. It can identify compulsive exercise among patients with eating disorders and a cut-off score of 15 is acceptable as indicating an appropriate cut-off point

Levels of depression in transgender people and its predictors: Results of a large matched control study with transgender people accessing clinical services

Background Depression is a serious disorder which significantly impacts wellbeing and quality of life. Studies exploring mental wellbeing in the transgender population are mostly limited by small, non-homogenous samples and lack of matched controls. This study aimed to address these limitations and explore depression rates in a large sample of transgender people, compared with matched controls from the general population, as well as factors predicting depression in those taking cross-sex hormone treatment (CHT) compared to those not. Methods Transgender individuals (n=913) completed a measure of depression, measures which predict psychopathology (self-esteem, victimization, social support, interpersonal problems), and information regarding CHT use. Participants were matched by age and experienced gender with adults from the general population who had completed the measure of depression. Results Individuals were categorized as having no, possible or probable depressive disorder. Transgender individuals not on CHT had a nearly four-fold increased risk of probable depressive disorder, compared to controls. Older age, lower self-esteem, poorer interpersonal function and less social support predicted depressive disorder. Use of CHT was associated with less depression. Limitations Participants were attending a national gender identity service and therefore represent only a sub-group of transgender people. Due to the cross-sectional design, longitudinal research is required to fully confirm the finding that CHT use reduces depression. Conclusion This study confirms that non-treated transgender individuals have an increased risk of a depressive disorder. Interventions offered alongside gender affirming treatment to develop interpersonal skills, increase self-esteem and improve social support may reduce depression and prepare individuals for a more successful transition

Body image dissatisfaction and eating-related psychopathology in trans individuals: a matched control study

High levels of body dissatisfaction have already been reported in the trans population; however, the root of this dissatisfaction, and its association with eating disordered behaviours, has not been studied in-depth. This study aims to assess eating disorder risk by comparing 200 trans people, 200 people with eating disorders and 200 control participants' scores on three subscales of the Eating Disorders Inventory-2 (EDI-2) and to further explore dissatisfaction in the trans participants using the Hamburg Body Drawing Scale (HBDS). The results showed that overall participants with eating disorders scored higher than trans or control groups on all EDI-2 measures, but that trans individuals had greater body dissatisfaction than control participants and, importantly, trans males had comparable body dissatisfaction scores to eating disordered males. Drive for thinness was greater in females (cis and trans) compared with males. In relation to HBDS body dissatisfaction, both trans males and trans females reported greatest dissatisfaction not only for gender-identifying body parts but also for body shape and weight. Overall, trans males may be at particular risk for eating disordered psychopathology and other body image-related behaviours

Predictors of positive treatment outcome in people with anorexia nervosa treated in a specialized inpatient unit: The role of early response to treatment

o investigate factors which predict positive treatment outcome in inpatients with anorexia nervosa (AN), particularly the role of early treatment response. METHOD: 102 patients entering specialist inpatient treatment were assessed for eating disorder history, psychopathology and motivation to change. Predictive factors assessed were: early treatment response defined as weight increase of at least 0.5-1 kg/week during the first six weeks of treatment; admission BMI; onset age; chronicity; motivation to change; diagnosis; and previous hospitalization for AN. Positive treatment outcome was defined as achieving BMI 17.5 kg/m2 within an individual timeframe. RESULTS: Logistic regression indicated that patients were 18 times more likely to reach positive treatment outcome if they met NICE weight guidelines within the first six weeks of hospitalization. Higher admission BMI was also found to predict positive treatment outcome. DISCUSSION: Higher entry BMI and early weight gain predict positive treatment outcome in individuals receiving specialist AN inpatient treatment

Evaluation of a motivation and psycho-educational guided self help intervention for people with eating disorders (MOPED)

High dropout rates and poor levels of engagement are well documented for patients with eating disorders. Utilising motivational techniques and providing psycho-education have been suggested as ways to reduce treatment disengagement. This study aimed to evaluate the effect of a newly developed motivational and psycho-educational guided self-help intervention (MOPED) for people with eating disorders on engagement and retention in therapy. Patients who received MOPED pre-treatment (n = 79) were compared to a diagnosis matched group of patients receiving treatment as usual (TAU; n = 79). The study found that patients receiving MOPED had a higher engagement rate than those within the TAU group. Specifically, patients in the anorexic spectrum were found to present with both higher rates of engagement and completion of therapy when issued with MOPED in comparison to TAU. Self-help packages using motivational style could be a valuable and cost effective intervention for patients with eating disorders

Comparison for clinical variables between countries (China, UK and Spain).

<p>Comparison for clinical variables between countries (China, UK and Spain).</p