The Psychological Effects of Short-Term Fasting in Healthy Women.

OBJECTIVE: The study aimed to investigate affective responses to 18-h fasting in healthy controls. In particular, the study focused on self-reported mood, irritability, sense of achievement, reward, pride, and control. METHOD: Participants were a non-clinical sample of 52 women with a mean age of 25. A repeated-measures design was used, whereby participants provided diary measures of psychological variables throughout both 18-h fasting and non-fasting periods. RESULTS: Fasting led to increased irritability, and also to positive affective experiences of increased sense of achievement, reward, pride, and control. DISCUSSION: Even short-term fasting in healthy controls can lead to positive psychological experiences. This lends support to cognitive-behavioral and cognitive-interpersonal models of ANR, which suggest that dietary restriction is maintained through positive reinforcement

How well does Anorexia Nervosa fit with personal values? An exploratory study.

BACKGROUND: Despite an increasing clinical interest in the use of personal values as a motivational tool in psychological therapies for Anorexia Nervosa (AN), research is limited. This study explored personal values among individuals with AN, with a particular focus on the 'fit' between participants' values and their AN. METHODS: A qualitative research design was employed in this study. In-depth, semi-structured interviews were carried out among eight female outpatients and inpatients with a diagnosis of AN or Eating Disorder Not Otherwise Specified - AN type (EDNOS-AN type). Data was analysed using Interpretative Phenomenological Analysis (IPA; Smith, Jarman & Osborne, 1999). RESULTS: Three super-ordinate themes emerged from analysis: 'Balancing Values' (difficulty finding balance in relating to and acting on values), 'Congruence and Clashes between AN and Values' (experiences of AN representing a mixed-fit with values) and 'From Ambivalence to Motivation' (ambivalence toward both AN and recovery - in the context of its mixed-fit with values - and experiences of values as a motivational tool in recovery). CONCLUSIONS: Study findings support a role for psychological therapies in working with personal values as a means of promoting recovery in AN, through supporting individuals to explore AN's workability in the context of their values. Further research investigating the optimal stage of treatment to work with values as a motivational tool is warranted

Effects of HIV status and linguistic medium on the test performance of rural low-literacy adults: implications for neuropsychological test development in Zambia

Purpose of the study: The purpose of the study was to determine whether the familiar language (Chichewa version) could contribute to the early diagnosis of neurocognitive dysfunctions and develop a battery of locally valid tests capable of detecting early changes in the cognitive profile of neurocognitive dysfunctions among HIV positive patients.Research question one: What is the difference in performance between HIV negative and HIV positive individuals when they are subjected to the four verbal tests of the neuropsychological test battery using the English and Chichewa versions?Research question two: What is the interaction effect among the influences of HIV status, linguistic medium and gender on the four verbal tests of the neuropsychological test battery?Design: It was an experimental design that assessed the neuropsychological effects of HIV status and linguistic medium on the test performance. The Hopkins Verbal Learning Test (HVLT-R) for both immediate and delayed recall were used to test the verbal episodic memory from the Verbal Learning and Memory Recall Domain (Brandt and Benedict, 2001). Other tests included Animal and Action Naming. These tests were translated into Chichewa and administered to 28 HIV positive and 22 HIV negative rural low illiterate adults aged between 40 and 65 years.Results: On all the Neuropsychological tests administered, HIV positive respondents scored significantly lower than HIV negative respondents, and the mean scores on the English medium version were consistently lower than scores on the L1 (Chichewa) version across all tests and all groups.Conclusion: The study has shown that the primary language is best suited to test neurocognitive performance and especially when one is using test components that do not require reading or writing

The role of self-compassion and self-criticism in binge eating behaviour

Self-criticism and low self-compassion are implicated in the development and maintenance of binge eating. However, the association between these self-attitudes and binge eating symptoms remains unclear. Women with symptoms of Bulimia Nervosa (BN) or Binge Eating Disorder (BED) were randomised to either a self-compassion (n = 30) or self-critical rumination (n = 30) strategy following a negative mood induction. Responses to food cues (cue reactivity and affect) and calorie consumption in a ‘taste test’ were assessed. The self-compassion strategy was associated with a greater improvement in positive and negative affect following the negative mood induction. Despite the differential effects on mood, self-compassion and self-critical rumination led to similar self-reported food cravings and physiological reactivity to cues. However, participants in the self-compassion condition consumed significantly fewer calories, rated the consumed food as less pleasurable, and reported less desire to continue eating. The findings suggest that therapeutic strategies for cultivating self-compassion are associated with improved food-related self-regulation in the context of negative mood

Improving the post-meal experience of hospitalised patients with eating disorders using visuospatial, verbal and somatic activities

BACKGROUND: This study compares the effects of different cognitive tasks on post-meal negative affect, positive affect, intrusive thoughts and intrusive images of hospitalised patients with eating disorders. METHODS: Twenty-five participants were recruited from an eating disorder service. Using a within-subjects design, participants performed one of the following tasks for 15 min: the game 'Tetris' (visuospatial), a general knowledge 'Quiz' (verbal), 'Braille' translation (somatic) and 'Sitting Quietly' (control). In total, participants completed each task on three occasions. RESULTS: The visuospatial, verbal and somatic tasks had beneficial effects on all positive and negative indicators, when compared with 'Sitting Quietly'. Visuospatial and somatic tasks were more effective at reducing intrusive imagery than the verbal task. CONCLUSIONS: The results suggest that certain engaging activities can help hospitalised patients with eating disorders manage the difficult post-meal period

Systematic review of risk factors for eating psychopathology in athletes: A critique of an etiological model

Objective: The theoretical model by Petrie and Greenleaf (2007, 2012) is an admirable attempt to collate the causal factors of disordered eating in athletes. The aims of this systematic review are (a) to provide an overview of the findings from the relevant literature, (b) to assess whether the model is supported by the existing research, (c) to evaluate the different designs, methods, and measures used to test the mediators in the model, and (d) to highlight areas for improvements and future research. Method: A systematic review of four major online databases identified 37 relevant papers on risk factors of disordered eating in athletes, which were reviewed and critically compared with the theoretical model. Results: There is a lack of longitudinal research with the relevant mediators in athlete populations, which makes it difficult to determine whether the potential mediators described by Petrie and Greenleaf are causal risk factors rather than simply correlates of disordered eating for athletes. Findings for all the potential mediators are inconsistent, and the range of measures used makes it problematic to draw conclusions. Conclusions: Future research needs to use gold standard measures and longitudinal designs in order to fully test and possibly update the model

Interviewing anorexia: How do individuals given a diagnosis of anorexia nervosa experience Voice Dialogue with their eating disorder voice? A qualitative analysis

A proportion of individuals given an eating disorder diagnosis describe the experience of an eating disorder ‘voice’ (EDV). However, methods for working with this experience are currently lacking. Voice Dialogue (Stone & Stone, 1989) involves direct communication between a facilitator and parts of the self to increase awareness, understanding, and separation from inner voices. Adapted forms of this method have shown promise in working with voices in psychosis. This study aimed to explore the experience and acceptability of Voice Dialogue amongst individuals with anorexia nervosa who experience an EDV. Nine women participated in a semistructured interview following a single Voice Dialogue session. Interview transcripts were analysed using interpretative phenomenological analysis (IPA). Three overarching themes were identified as follows: (i) “separating from the EDV”; (ii) “better understanding of the EDV”; and (iii) “hopeful, motivated, and afraid of recovery”. The majority of participants found Voice Dialogue acceptable and helpful for exploring their EDV. Whilst preliminary, the results suggest that Voice Dialogue has potential in terms of helping individuals establish a more constructive relationship with their EDV and motivating change. Further research is needed to build upon these findings. Implications for addressing the EDV using voice-focused interventions are explored

A systematic review of the effects of experimental fasting on cognition

Numerous investigations have been conducted on the impact of short-term fasting on cognition in healthy individuals. Some studies have suggested that fasting is associated with executive function deficits; however, findings have been inconsistent. The lack of consensus regarding the impact of short-term fasting in healthy controls has impeded investigation of the impact of starvation or malnutrition in clinical groups, such as anorexia nervosa (AN). One method of disentangling these effects is to examine acute episodes of starvation experimentally. The present review systematically investigated the impact of short-term fasting on cognition. Studies investigating attentional bias to food-related stimuli were excluded so as to focus on general cognition. Ten articles were included in the review. The combined results are equivocal: several studies report no observable differences as a result of fasting and others show specific deficits on tasks designed to test psychomotor speed, executive function, and mental rotation. This inconsistent profile of fasting in healthy individuals demonstrates the complexity of the role of short-term fasting in cognition; the variety of tasks used, composition of the sample, and type and duration of fasting across studies may also have contributed to the inconsistent profile. Additional focused studies on neuropsychological profiles of healthy individuals are warranted in order to better develop an understanding of the role of hunger in cognition

The effect of intranasal oxytocin on the perception of affective touch and multisensory integration in anorexia nervosa: protocol for a double-blind placebo-controlled crossover study.

INTRODUCTION: Anorexia nervosa (AN) is an eating disorder characterised by restriction of energy intake, fears of gaining weight and related body image disturbances. The oxytocinergic system has been proposed as a pathophysiological candidate for AN. Oxytocin is a neuropeptide involved in bodily processes (eg, breast feeding) and in the onset of social behaviours (eg, bonding). Studies investigating the effect of intranasal oxytocin (IN-OT) in AN showed that it can improve attentional bias for high-calorie food and fat bodies stimuli, and related stress. However, less is known about the effect of IN-OT on bodily awareness and body image distortions, key features of the disorder linked to its development, prognosis and maintenance. Here, we aim to investigate the effect of IN-OT on the perception of affective, C-tactile-optimal touch, known to be impaired in AN and on multisensory integration processes underlying a body ownership illusion (ie, rubber hand illusion). For exploratory purposes, we will also investigate the effect of IN-OT on another interoceptive modality, namely cardiac awareness and its relationship with affective touch. DESIGN, METHODS AND ANALYSIS: Forty women with AN and forty matched healthy controls will be recruited and tested in two separate sessions; self-administering IN-OT (40 IU) or placebo, intranasally, in a pseudo-randomised manner. The data from this double-blind, placebo-controlled, cross-over study will be analysed using linear mixed models that allow the use of both fixed (treatment levels) and random (subjects) effects in the same analysis. To address our main hypotheses, separate analyses will be run for the affective touch task, where the primary outcome dependent variable will be the pleasantness of the touch, and for the rubber hand illusion, where we will investigate multisensory integration quantified as subjective embodiment towards the rubber hand. In the latter, we will manipulate the synchronicity of touch and the size of the hand. ETHICS AND DISSEMINATION: Ethics approval has been obtained by National Research Ethics Service NRES Committee London (Queen's Square Committee, ref number 14/LO/1593). The results will be disseminated through conference presentations and publication in peer-reviewed journals

A Qualitative Exploration of Sport and Social Pressures on Elite Athletes in Relation to Disordered Eating

Introduction: Athletes are at increased risk of disordered eating compared to non-athletes. Inspired by previous investigation into quantitative work on an etiological model of disordered eating in athletes, the current study aimed to explore a problematic aspect of the model: athletes' lived experiences of social and sport pressures in relation to the onset of disordered eating and differing eating behaviors. / Methods: Nine (N = 9) male and female athletes representing a range of endurance sports took part in semi-structured interviews. Thematic analysis was utilized. / Analysis: Analysis revealed two main themes each with two corresponding subthemes (1) Conflating physical appearance and sporting ability with the subthemes of (1a) social comparison in a sporting world and (1b) societal notions of “the athlete body” and (2) Living as an athlete with the corresponding subthemes of (2a) discipline and sacrifice and (2b) the balancing act. / Discussion: It is the complex interaction between societal expectations as lived out in social messages and comparisons, and sport pressures that contributes to the development of disordered eating behaviors. These findings suggest that prevention and treatment of disordered eating in athletes can be applied from those already established in non-sporting realm