Disorder-specific versus generic cognitive-behavioural treatment of anxiety disorders in children and young people: A systematic narrative review of evidence for the effectiveness of disorder-specific CBT compared with the disorder-generic treatment Coping Cat

BackgroundCoping Cat (CC), a generic cognitive-behavioral intervention for anxiety disorders in children and young people, is recommended in the United Kingdom for social anxiety disorder (SAD), generalized anxiety disorder, separation anxiety (SA), and specific phobias (SP), with disorder-specific approaches generally favored in treatment of anxiety disorders in adults.ObjectivesTo compare CC with disorder-specific cognitive-behavioral therapy (CBT) interventions based on anxiety-related treatment outcomes.Study SelectionPrimary research articles describing treatment of children and young people aged 7–17 for SAD, generalized anxiety disorder, SA, and SP, using CC or disorder-specific CBT.ResultsTen studies implemented CC and four implemented disorder-specific CBT. One study compared CC with a disorder-specific approach. There was a lack of data to support use of CC in treatment of SPs. However, CC was equally effective as disorder-specific treatments for SA and SAD.ConclusionsA lack of data exists for disorder-specific CBT interventions compared to CC

A dynamic network approach for the study of human phenotypes

The use of networks to integrate different genetic, proteomic, and metabolic datasets has been proposed as a viable path toward elucidating the origins of specific diseases. Here we introduce a new phenotypic database summarizing correlations obtained from the disease history of more than 30 million patients in a Phenotypic Disease Network (PDN). We present evidence that the structure of the PDN is relevant to the understanding of illness progression by showing that (1) patients develop diseases close in the network to those they already have; (2) the progression of disease along the links of the network is different for patients of different genders and ethnicities; (3) patients diagnosed with diseases which are more highly connected in the PDN tend to die sooner than those affected by less connected diseases; and (4) diseases that tend to be preceded by others in the PDN tend to be more connected than diseases that precede other illnesses, and are associated with higher degrees of mortality. Our findings show that disease progression can be represented and studied using network methods, offering the potential to enhance our understanding of the origin and evolution of human diseases. The dataset introduced here, released concurrently with this publication, represents the largest relational phenotypic resource publicly available to the research community.Comment: 28 pages (double space), 6 figure

No effect of focused attention whilst eating on later snack food intake: Two laboratory experiments

Focusing attention on food during a meal has been shown to reduce later snack consumption. We report the results of two studies that aimed to replicate this effect and to elucidate the underlying mechanisms. We hypothesised that focused attention during a lunchtime meal would improve visual memory and/or memory for the satiating effects of the meal, and that this would reduce later food intake. In Study 1, participants (N = 108, 52.8% female, BMI M = 25.75 kg/m²) were randomly allocated to eat a fixed lunchtime meal while listening to instructions that encouraged them to pay attention to the sensory properties of the meal (focused attention condition), or to one of two control conditions. To determine whether the effect of focused attention on later food intake is influenced by meal satisfaction, in a second study, participants (N = 147, 100% female, BMI M = 25.15 kg/m²) were given either a satisfying or dissatisfying lunch. In both studies, after 3 h participants ate snack food ad libitum and completed assessments of their memory for the recent lunch. In both studies there was no effect of focused attention on later food intake. In Study 2, the effect of focused attention on later food intake was not moderated by meal satisfaction. In both studies focused attention did not improve memory for the lunch meal. The present studies failed to replicate the effect of focused attention on later food intake and this may be because focused attention did not improve memory for the lunchtime meal. Further research should examine the conditions under which attention during eating influences memory encoding and food intake

Keeping Pace with Your Eating: Visual Feedback Affects Eating Rate in Humans

Deliberately eating at a slower pace promotes satiation and eating quickly has been associated with a higher body mass index. Therefore, understanding factors that affect eating rate should be given high priority. Eating rate is affected by the physical/textural properties of a food, by motivational state, and by portion size and palatability. This study explored the prospect that eating rate is also influenced by a hitherto unexplored cognitive process that uses ongoing perceptual estimates of the volume of food remaining in a container to adjust intake during a meal. A 2 (amount seen; 300ml or 500ml) x 2 (amount eaten; 300ml or 500ml) between-subjects design was employed (10 participants in each condition). In two ‘congruent’ conditions, the same amount was seen at the outset and then subsequently consumed (300ml or 500ml). To dissociate visual feedback of portion size and actual amount consumed, food was covertly added or removed from a bowl using a peristaltic pump. This created two additional ‘incongruent’ conditions, in which 300ml was seen but 500ml was eaten or vice versa. We repeated these conditions using a savoury soup and a sweet dessert. Eating rate (ml per second) was assessed during lunch. After lunch we assessed fullness over a 60-minute period. In the congruent conditions, eating rate was unaffected by the actual volume of food that was consumed (300ml or 500ml). By contrast, we observed a marked difference across the incongruent conditions. Specifically, participants who saw 300ml but actually consumed 500ml ate at a faster rate than participants who saw 500ml but actually consumed 300ml. Participants were unaware that their portion size had been manipulated. Nevertheless, when it disappeared faster or slower than anticipated they adjusted their rate of eating accordingly. This suggests that the control of eating rate involves visual feedback and is not a simple reflexive response to orosensory stimulatio

The Drosophila deoxyhypusine hydroxylase homologue nero and its target eIF5A are required for cell growth and the regulation of autophagy

Hypusination is a unique posttranslational modification by which lysine is transformed into the atypical amino acid hypusine. eIF5A (eukaryotic initiation factor 5A) is the only known protein to contain hypusine. In this study, we describe the identification and characterization of nero, the Drosophila melanogaster deoxyhypusine hydroxylase (DOHH) homologue. nero mutations affect cell and organ size, bromodeoxyuridine incorporation, and autophagy. Knockdown of the hypusination target eIF5A via RNA interference causes phenotypes similar to nero mutations. However, loss of nero appears to cause milder phenotypes than loss of eIF5A. This is partially explained through a potential compensatory mechanism by which nero mutant cells up-regulate eIF5A levels. The failure of eIF5A up-regulation to rescue nero mutant phenotypes suggests that hypusination is required for eIF5A function. Furthermore, expression of enzymatically impaired forms of DOHH fails to rescue nero clones, indicating that hypusination activity is important for nero function. Our data also indicate that nero and eIF5A are required for cell growth and affect autophagy and protein synthesis

The effects of mindful eating on food consumption over a half-day period

This study examined the effects of a key feature of mindful eating (paying attention to the sensory properties of food) on calorie and macronutrient intake over a half-day period. Female participants (n = 60) were given a 635 kcal lunch of sandwiches, crisps and grapes. Those allocated to an experimental condition were asked to attend to the sensory properties of the food. After lunch, all participants were given 908 kcal of three energy dense sweet snack foods and asked to taste and rate them on several dimensions. Unknown to participants, the amounts of all foods consumed were recorded. Before they left the laboratory, participants in the experimental group were also asked to continue to pay attention to the sensory properties of their food for the rest of the day. At the end of the day all participants logged onto a website where they completed a suspicion probe and surprise online food recall measure to assess food intake outside the laboratory. Data from participants who guessed their eating was being measured were excluded. There were no differences between the experimental and control groups in terms of calories consumed during the taste test (166 versus 144 kcal respectively; n = 48) or across the entire half-day period (1456 versus 1343 kcal respectively; n = 44). There were also no differences in total intake of saturated fat, added sugar or fibre. The results fail to support other research that has shown reductions in food intake following mindful eating. This highlights the need to identify underlying mechanisms of action to better understand when this strategy is, and is not, likely to influence diet

Can Existing Knowledge on Eating Behaviors and Obesity Support People with Cystic Fibrosis Who Are Nutritionally Compromised?

Nutritional status is a key predictor of health outcomes and survival for individuals with Cystic Fibrosis (CF). A main concern is the maintenance of a healthy body weight by eating a high-energy and high-fat diet (Abbott et al., 2008). This diet is accompanied for most patients with pancreatic enzyme replacement therapy, and for some patients with fat soluble vitamins, oral supplements, and enteral tube feeding which further supports the high nutritional requirements (Powers et al., 2002). Nevertheless, inadequate intake in CF remains a major problem within CF populations due to a number of complex reasons including physiological factors such as anorexia or poor appetite (Durie and Pencharz, 1989), early satiety and abdominal pain (Pumariega et al., 1986). Social and psychological factors for inadequate intake in CF include feeling under pressure to eat (Abbott et al., 2008), and being afraid of choking (Murphy and Wootton, 1998). The latest Cystic Fibrosis Foundation Registry Report (2004) indicates that approximately 31% showed symptomatology consistent with malnutrition. This paper suggests possibilities for developing research further and enhancing behavioral interventions for malnourished individuals with CF. With a paucity of research on the experiences of eating in adults with CF, known information around eating in other populations should be explored. Findings in obesity research may provide useful suggestions for environmental and behavioral interventions with malnourished individuals until a healthy weight status is achieved