Implicit cognitive processes in binge-eating disorder and obesity

Objectives: Binge-eating disorder (BED) is characterized by recurrent binge eating episodes, associated eating disorder and general psychopathology, and commonly occurs in obese individuals. Explicit self-esteem and explicit weight bias have been linked to BED, while little is known about implicit cognitive processes such as implicit self-esteem and implicit weight bias. Methods: Obese participants with BED and an individually matched obese only group (OB) and normal weight control group (CG; each N = 26) were recruited from the community to examine group differences and associations in explicit and implicit self-esteem and weight bias, as well as the impact of implicit cognitive processes on global eating disorder psychopathology. Implicit cognitive processes were assessed using the Implicit Association Test. Results: Significantly lower explicit self-esteem, as well as higher exposure to explicit weight bias, compared to CG and OB was found in the BED group. All groups showed positive implicit self-esteem, however, it was significantly lower in BED when compared to CG. BED and CG demonstrated equally high implicit weight bias whereas OB did not. Explicit and implicit measures were not significantly correlated. Global eating disorder psychopathology was predicted by explicit and implicit self-esteem. Conclusions: The results of the present study add to the importance of implicit self-esteem and implicit weight bias beyond explicit measures in BED, while both were previously shown to be associated with onset and maintenance of BED. In conclusion, implicit cognitive processes should be focused on in interventions for BED to investigate their impact on psychological treatments

Through a glass, less darkly? Reassessing convergent and divergent validity in measures of implicit self-esteem

Self-esteem has been traditionally assessed via self-report (explicit self-esteem: ESE). However, the limitations of self-report have prompted efforts to assess self-esteem indirectly (implicit self-esteem: ISE). It has been theorized that ISE and ESE reflect the operation of largely distinct mental systems. However, although low correlations between measures of ISE and ESE empirically support their discriminant validity, similarly low correlations between different measures of ISE do not support their convergent validity. We explored whether such patterns would reemerge if more recently developed, specific, and reliable ISE measures were used. They did, although some convergent validity among ISE measures emerged once confounds resulting from conceptual mismatch, individual differences, and random variability were minimized. Nonetheless, low correlations among ISE measures are not primarily caused by the usual psychometric suspects, and may be the result of other factors including subtle differences between structural features of such measures

Psychosocial status and mental health in adolescents before and after bariatric surgery: a systematic literature review

Objective: As long-term results of conservative treatment for obesity are discouraging, bariatric surgery is becoming a treatment option for extremely obese adolescents. However, mental and behavioral problems need to be respected when treating this vulnerable target group. Methods: A detailed systematic literature review on pre- and post-operative depressive, anxiety and eating disorder symptoms of adolescent patients was performed in PsychINFO, PubMed and Medline electronic databases. Results: Twelve studies met the inclusion criteria. Although strength of evidence was limited, results suggested that pre-operatively a third of adolescents suffered from moderate to severe depressive disorder symptoms and a quarter from anxiety disorder symptoms, while a substantial number showed eating disorder symptoms. Post-operatively, levels of depressive disorder symptoms significantly improved. Original articles on outcomes of eating and anxiety disorder symptoms after weight loss surgery were not found. Conclusions: Further attention is needed on consistent clinical assessment of mental health disturbances and their consecutive treatment in adolescents. Future research should also focus on psychological and psychosocial predictors of weight loss after bariatric surgery

A novel measure to assess self-discrimination in binge eating disorder and obesity

Stigmatized obese individuals tend to internalize the pervasive weight stigma which might lead to self-discrimination and increased psychopathology. While explicit and implicit weight stigma can be measured using self-report questionnaires and Implicit Association Tests (IAT), respectively, the assessment of self-discrimination relied solely on self-report. The present study sought to develop an IAT measuring implicit self-discrimination (SD-IAT) in samples of obese individuals with and without binge-eating disorder (BED). Seventy-eight individuals were recruited from the community and individually matched in three groups. Obese participants with BED, obese participants without BED (OB), and a normal weight control group without eating disorder psychopathology (HC) were assessed with the SD-IAT and other measures relevant for convergent and discriminant validation. Results revealed significantly higher implicit self-discrimination in the BED group when compared to both OB and HC. Furthermore, significant correlations were found between the SD-IAT with body mass index, experiences of weight stigma, depressive symptoms, and implicit self-esteem. Finally, implicit self-discrimination predicted eating disorder psychopathology over and above group membership, and experiences of weight stigma. This study provides first evidence of the validity of the SD-IAT. Assessing implicit self-discrimination might further increase understanding of weight stigma and its significance for psychosocial functioning among vulnerable obese individuals

Two sides of weight bias in adolescent binge-eating disorder: adolescents’ perceptions and maternal attitudes

Objective: Adolescents with binge-eating disorder (BED) are suffering from weight teasing and, as found in adults with BED, are likely to internalize weight bias. Weight teasing by mothers accounts for psychopathology in overweight, but sources of stigmatization are largely unknown in BED. This study sought to address familial weight bias in adolescents with overweight and BED by examining adolescents’ perceived parental weight teasing and weight bias internalization in relation to their eating disorder psychopathology and maternal stigmatizing attitudes and beliefs. Method: Adolescents with overweight and BED (BED; n = 40) were compared to a socio-demographically matched group with overweight only (OW) and a normal-weight control group (NW; each n = 25). They filled out the Perception of Teasing Scale, with parents as the source of teasing, the Weight Bias Internalization Scale and the Eating Disorder Examination-Questionnaire. Their mothers filled out the Attitudes Toward and Beliefs about Obese Persons Scales. Results: Significantly higher perceived parental weight teasing and weight bias internalization were found in BED compared to OW and NW. Maternal stigmatizing attitudes and beliefs did not differ between groups and were not correlated with adolescents’ perceptions of being stigmatized. Perceived parental weight teasing predicted adolescents’ eating disorder psychopathology, however, this association was fully mediated by weight bias internalization. Discussion: These results indicate that adolescents with overweight and BED perceive weight teasing in their own families. As we found no significant association between adolescents’ perceptions of being stigmatized and maternal stigmatizing attitudes, future research should examine weight-related parent-child interaction or implicit measures of stigmatizing attitudes

Weight bias internalization, emotion dysregulation, and non-normative eating behaviors in prebariatric patients

Objective: Weight bias internalization (WBI) is associated with eating disorder psychopathology and non-normative eating behaviors among individuals with overweight and obesity, but has rarely been investigated in prebariatric patients. Based on findings demonstrating a relationship between emotion dysregulation and eating behavior, this study sought to investigate the association between WBI and eating disorder psychopathology as well as non-normative eating behaviors (i.e., food addiction, emotional eating, and eating in the absence of hunger), mediated by emotion dysregulation. Method: Within a consecutive multicenter study, 240 prebariatric patients were assessed using self-report questionnaires. The mediating role of emotion dysregulation was examined using structural equation modeling. Results: The analyses yielded no mediational effect of emotion dysregulation on the association between WBI and eating disorder psychopathology. However, emotion dysregulation fully mediated the associations between WBI and emotional eating as well as eating in the absence of hunger. Further, emotion dysregulation partially mediated the relationship between WBI and food addiction symptoms. Discussion: Prebariatric patients with high levels of WBI are at risk for non-normative eating behaviors, especially if they experience emotion regulation difficulties. These findings highlight the importance of interventions targeting WBI and improving emotion regulation skills for the normalization of eating behavior in prebariatric patients

Non-normative eating behavior and psychopathology in prebariatric patients with binge-eating disorder and night eating syndrome

Background: Binge-eating disorder (BED) as a distinct eating disorder category and night eating syndrome (NES) as a form of Other Specified Feeding or Eating Disorders were recently included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Objectives: This study sought to investigate the prevalence of BED and NES and associations with various forms of non-normative eating behavior and psychopathology in prebariatric patients. Setting: Within a consecutive multicenter registry study, patients in six bariatric surgery centers in Germany were recruited. Methods: Overall, 233 prebariatric patients were assessed using the Eating Disorder Examination and self-report questionnaires. Assessment was unrelated to clinical procedures. Results: Diagnostic criteria for full-syndrome BED and NES were currently met by 4.3% and 8.2% of prebariatric patients, respectively. In addition, 8.6% and 6.9% of patients met subsyndromal BED and NES criteria, respectively. Comorbid BED and NES diagnoses were present in 3.9% of patients. In comparison to patients without any eating disorder symptoms, patients with BED and NES reported greater emotional eating, eating in the absence of hunger, and more symptoms of food addiction. Moreover, differences between patients with BED and NES emerged with more objective binge eating episodes and higher levels of eating concern, weight concern, and global eating disorder psychopathology in patients with BED. Conclusions: BED and NES were shown to be prevalent among prebariatric patients, with some degree of overlap between diagnoses. Associations with non-normative eating behavior and psychopathology point to their clinical significance and discriminant validity

Non-normative eating behavior and psychopathology in prebariatric patients with binge-eating disorder and night eating syndrome

Background: Binge-eating disorder (BED) as a distinct eating disorder category and night eating syndrome (NES) as a form of Other Specified Feeding or Eating Disorders were recently included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Objectives: This study sought to investigate the prevalence of BED and NES and associations with various forms of non-normative eating behavior and psychopathology in prebariatric patients. Setting: Within a consecutive multicenter registry study, patients in six bariatric surgery centers in Germany were recruited. Methods: Overall, 233 prebariatric patients were assessed using the Eating Disorder Examination and self-report questionnaires. Assessment was unrelated to clinical procedures. Results: Diagnostic criteria for full-syndrome BED and NES were currently met by 4.3% and 8.2% of prebariatric patients, respectively. In addition, 8.6% and 6.9% of patients met subsyndromal BED and NES criteria, respectively. Comorbid BED and NES diagnoses were present in 3.9% of patients. In comparison to patients without any eating disorder symptoms, patients with BED and NES reported greater emotional eating, eating in the absence of hunger, and more symptoms of food addiction. Moreover, differences between patients with BED and NES emerged with more objective binge eating episodes and higher levels of eating concern, weight concern, and global eating disorder psychopathology in patients with BED. Conclusions: BED and NES were shown to be prevalent among prebariatric patients, with some degree of overlap between diagnoses. Associations with non-normative eating behavior and psychopathology point to their clinical significance and discriminant validity

Journeys from quantum optics to quantum technology

Sir Peter Knight is a pioneer in quantum optics which has now grown to an important branch of modern physics to study the foundations and applications of quantum physics. He is leading an effort to develop new technologies from quantum mechanics. In this collection of essays, we recall the time we were working with him as a postdoc or a PhD student and look at how the time with him has influenced our research