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1. Genome-wide copy number variation association study in anorexia nervosa

Author

Walker, Alicia, Karlsson, Robert, Szatkiewicz, Jin P., Thornton, Laura M., Yilmaz, Zeynep, Leppä, Virpi M., Savva, Androula, Lin, Tian, Sidorenko, Julia, McRae, Allan, Kirov, George, Davies, Helena L., Fundín, Bengt T., Chawner, Samuel J. R. A., Song, Jie, Borg, Stina, Wen, Jia, Watson, Hunna J., Munn-Chernoff, Melissa A., Baker, Jessica H., Gordon, Scott, Berrettini, Wade H., Brandt, Harry, Crawford, Steven, Halmi, Katherine A., Kaplan, Allan S., Kaye, Walter H., Mitchell, James, Strober, Michael, Woodside, D. Blake, Pedersen, Nancy L., Parker, Richard, Jordan, Jennifer, Kennedy, Martin A., Birgegård, Andreas, Landén, Mikael, Martin, Nicholas G., Sullivan, Patrick F., Bulik, Cynthia M., and Wray, Naomi R.

Published
2024
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9. Brain Structure in Acutely Underweight and Partially Weight-Restored Individuals With Anorexia Nervosa: A Coordinated Analysis by the ENIGMA Eating Disorders Working Group

Author

Walton, Esther, Bernardoni, Fabio, Batury, Victoria-Luise, Bahnsen, Klaas, Larivière, Sara, Abbate-Daga, Giovanni, Andres-Perpiña, Susana, Bang, Lasse, Bischoff-Grethe, Amanda, Brooks, Samantha J., Campbell, Iain C., Cascino, Giammarco, Castro-Fornieles, Josefina, Collantoni, Enrico, D’Agata, Federico, Dahmen, Brigitte, Danner, Unna N., Favaro, Angela, Feusner, Jamie D., Frank, Guido K.W., Friederich, Hans-Christoph, Graner, John L., Herpertz-Dahlmann, Beate, Hess, Andreas, Horndasch, Stefanie, Kaplan, Allan S., Kaufmann, Lisa-Katrin, Kaye, Walter H., Khalsa, Sahib S., LaBar, Kevin S., Lavagnino, Luca, Lazaro, Luisa, Manara, Renzo, Miles, Amy E., Milos, Gabriella F., Monteleone, Alessio Maria, Monteleone, Palmiero, Mwangi, Benson, O’Daly, Owen, Pariente, Jose, Roesch, Julie, Schmidt, Ulrike H., Seitz, Jochen, Shott, Megan E., Simon, Joe J., Smeets, Paul A.M., Tamnes, Christian K., Tenconi, Elena, Thomopoulos, Sophia I., van Elburg, Annemarie A., Voineskos, Aristotle N., von Polier, Georg G., Wierenga, Christina E., Zucker, Nancy L., Jahanshad, Neda, King, Joseph A., Thompson, Paul M., Berner, Laura A., and Ehrlich, Stefan

Published
2022
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10. Common Genetic Variation and Age of Onset of Anorexia Nervosa

Author

Watson, Hunna J., Thornton, Laura M., Yilmaz, Zeynep, Baker, Jessica H., Coleman, Jonathan R.I., Adan, Roger A.H., Alfredsson, Lars, Andreassen, Ole A., Ask, Helga, Berrettini, Wade H., Boehnke, Michael, Boehm, Ilka, Boni, Claudette, Buehren, Katharina, Bulant, Josef, Burghardt, Roland, Chang, Xiao, Cichon, Sven, Cone, Roger D., Courtet, Philippe, Crow, Scott, Crowley, James J., Danner, Unna N., de Zwaan, Martina, Dedoussis, George, DeSocio, Janiece E., Dick, Danielle M., Dikeos, Dimitris, Dina, Christian, Djurovic, Srdjan, Dmitrzak-Weglarz, Monika, Docampo-Martinez, Elisa, Duriez, Philibert, Egberts, Karin, Ehrlich, Stefan, Eriksson, Johan G., Escaramís, Geòrgia, Esko, Tõnu, Estivill, Xavier, Farmer, Anne, Fernández-Aranda, Fernando, Fichter, Manfred M., Föcker, Manuel, Foretova, Lenka, Forstner, Andreas J., Frei, Oleksandr, Gallinger, Steven, Giegling, Ina, Giuranna, Johanna, Gonidakis, Fragiskos, Gorwood, Philip, Gratacòs, Mònica, Guillaume, Sébastien, Guo, Yiran, Hakonarson, Hakon, Hauser, Joanna, Havdahl, Alexandra, Hebebrand, Johannes, Helder, Sietske G., Herms, Stefan, Herpertz-Dahlmann, Beate, Herzog, Wolfgang, Hinney, Anke, Hübel, Christopher, Hudson, James I., Imgart, Hartmut, Jamain, Stephanie, Janout, Vladimir, Jiménez-Murcia, Susana, Jones, Ian R., Julià, Antonio, Kalsi, Gursharan, Kaminská, Deborah, Kaprio, Jaakko, Karhunen, Leila, Kas, Martien J.H., Keel, Pamela K., Kennedy, James L., Keski-Rahkonen, Anna, Kiezebrink, Kirsty, Klareskog, Lars, Klump, Kelly L., Knudsen, Gun Peggy S., La Via, Maria C., Le Hellard, Stephanie, Leboyer, Marion, Li, Dong, Lilenfeld, Lisa, Lin, Bochao, Lissowska, Jolanta, Luykx, Jurjen, Magistretti, Pierre, Maj, Mario, Marsal, Sara, Marshall, Christian R., Mattingsdal, Morten, Meulenbelt, Ingrid, Micali, Nadia, Mitchell, Karen S., Monteleone, Alessio Maria, Monteleone, Palmiero, Myers, Richard, Navratilova, Marie, Ntalla, Ionna, O’Toole, Julie K., Ophoff, Roel A., Padyukov, Leonid, Pantel, Jacques, Papežová, Hana, Pinto, Dalila, Raevuori, Anu, Ramoz, Nicolas, Reichborn-Kjennerud, Ted, Ricca, Valdo, Ripatti, Samuli, Ripke, Stephan, Ritschel, Franziska, Roberts, Marion, Rotondo, Alessandro, Rujescu, Dan, Rybakowski, Filip, Scherag, André, Scherer, Stephen W., Schmidt, Ulrike, Scott, Laura J., Seitz, Jochen, Silén, Yasmina, Šlachtová, Lenka, Slagboom, P. Eline, Slof-Op ‘t Landt, Margarita C.T., Slopien, Agnieszka, Sorbi, Sandro, Świątkowska, Beata, Tortorella, Alfonso, Tozzi, Federica, Treasure, Janet, Tsitsika, Artemis, Tyszkiewicz-Nwafor, Marta, Tziouvas, Konstantinos, van Elburg, Annemarie A., van Furth, Eric F., Walton, Esther, Widen, Elisabeth, Zerwas, Stephanie, Zipfel, Stephan, Bergen, Andrew W., Boden, Joseph M., Brandt, Harry, Crawford, Steven, Halmi, Katherine A., Horwood, L. John, Johnson, Craig, Kaplan, Allan S., Kaye, Walter H., Mitchell, James E., Olsen, Catherine M., Pearson, John F., Pedersen, Nancy L., Strober, Michael, Werge, Thomas, Whiteman, David C., Woodside, D. Blake, Gordon, Scott, Maguire, Sarah, Larsen, Janne T., Parker, Richard, Petersen, Liselotte V., Jordan, Jennifer, Kennedy, Martin, Wade, Tracey D., Birgegård, Andreas, Lichtenstein, Paul, Landén, Mikael, Martin, Nicholas G., Mortensen, Preben Bo, Breen, Gerome, and Bulik, Cynthia M.

Published
2022
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12. Early change in gastric‐specific anxiety sensitivity as a predictor of eating disorder treatment outcome.

Author

Velkoff, Elizabeth A., Lusich, Rylee, Kaye, Walter H., Wierenga, Christina E., and Brown, Tiffany A.

Subjects
ANXIETY treatment, TREATMENT of eating disorders, RISK assessment, QUESTIONNAIRES, INTERVIEWING, ANXIETY, TREATMENT effectiveness, DESCRIPTIVE statistics, DISCHARGE planning, EATING disorders, RESEARCH methodology, DATA analysis software, CONFIDENCE intervals, COMORBIDITY, GASTROINTESTINAL diseases, REGRESSION analysis, PATIENT aftercare, DISEASE risk factors
Abstract

Eating disorders (EDs) are often accompanied by gastrointestinal (GI) distress. Anxiety sensitivity is the tendency to interpret sensations of anxiety as threatening or dangerous, and includes both broad physical symptoms (e.g., elevated heartrate) and GI‐specific symptoms. Physical and GI‐specific anxiety sensitivity may be important risk and maintaining factors in EDs. This study tested the hypothesis that greater reductions in both types of anxiety sensitivity during the first month of treatment would predict lower ED symptoms and trait anxiety at discharge and 6‐month follow‐up. Patients (n = 424) in ED treatment reported physical and GI‐specific anxiety sensitivity, ED symptoms, and trait anxiety at treatment admission, 1‐month into treatment, discharge, and 6‐month follow‐up. Analyses were conducted with hierarchical linear regression with imputation, controlling for relevant covariates. Results indicated that early reduction in GI‐specific but not general physical anxiety sensitivity predicted both lower ED symptoms and lower trait anxiety at discharge and 6‐month follow‐up. These findings demonstrate the importance of GI‐specific anxiety sensitivity as a potential maintaining factor in EDs. Developing and refining treatments to target GI‐specific anxiety sensitivity may have promise in improving the treatment not only of EDs, but also of commonly co‐morbid anxiety disorders. Highlights: Anxiety sensitivity, the fear of symptoms of anxiety, is common in eating disorders (EDs), and may predict treatment outcomes.In this study, greater reduction in anxiety sensitivity for gastrointestinal symptoms within the first month of ED treatment predicted lower ED symptoms and anxiety at discharge from treatment but not 6‐month follow‐up. By contrast, reduction in more general physical anxiety sensitivity did not predict ED symptoms or anxiety at discharge or follow‐up.Findings highlight the importance of targeting anxiety about body sensations in treatment for EDs. [ABSTRACT FROM AUTHOR]

Published
2024
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15. Comparing changes in eating disorder psychopathology and comorbid symptoms over treatment in anorexia nervosa and atypical anorexia nervosa in a partial hospitalization program.

Author

Perry, Taylor R., Lusich, Rylee, Billman Miller, Marley G., Kaye, Walter H., Wierenga, Christina E., and Brown, Tiffany A.

Subjects
ANOREXIA nervosa treatment, PREVENTION of eating disorders, PREVENTION of mental depression, ANXIETY prevention, SELF-evaluation, RESEARCH funding, HOSPITAL care, ADULT day care, QUESTIONNAIRES, INTERVIEWING, TREATMENT effectiveness, DESCRIPTIVE statistics, COMPARATIVE studies, LENGTH of stay in hospitals, PATHOLOGICAL psychology, COMORBIDITY
Abstract

Objective: The objective of this study is to compare treatment trajectories in anorexia nervosa (AN) and atypical AN. Method: Adolescents and adults with AN (n = 319) or atypical AN (n = 67) in a partial hospitalization program (PHP) completed diagnostic interviews and self‐report questionnaires measuring eating disorder (ED), depression, and anxiety symptoms throughout treatment. Results: Premorbid weight loss did not differ between diagnoses. Individuals with atypical AN had more comorbid diagnoses, but groups did not differ on specific diagnoses. ED psychopathology and comorbid symptoms of depression/anxiety did not differ at admission between groups nor did rate of change in ED psychopathology and comorbid symptoms of depression/anxiety from admission to 1‐month. From admission to discharge, individuals with atypical AN had a faster reduction in ED psychopathology and comorbid symptoms of depression and anxiety (ps < 0.05; rs = 0.01–0.32); however, there were no group differences in ED psychopathology or depression symptoms at discharge (ps>.50; ds =.01–.30). Individuals with atypical AN had lower anxiety at discharge compared to individuals with AN (p = 0.05; d =.4). Length of stay did not differ between groups (p = 0.11; d =.21). Discussion: Groups had similar ED treatment trajectories, suggesting more similarities than differences. PHP may also be effective for AAN. Public Significance: This study supports previous research that individuals with AN and atypical AN have more similarities than differences. Results from this study indicate that individuals with AN and atypical AN have similar treatment outcomes for both ED psychopathology and depressive symptoms; however, individuals with atypical AN have lower anxiety symptoms at discharge compared to individuals with AN. AN and atypical AN also have more symptom similarity at admission and throughout treatment, which challenges their current designation as distinct disorders. [ABSTRACT FROM AUTHOR]

Published
2024
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16. Weight gained during treatment predicts 6‐month body mass index in a large sample of patients with anorexia nervosa using ensemble machine learning.

Author

Frank, Guido K. W., Stoddard, Joel J., Brown, Tiffany, Gowin, Josh, and Kaye, Walter H.

Subjects
ANOREXIA nervosa treatment, RANDOM forest algorithms, BODY mass index, PATIENTS, PREDICTION models, RESEARCH funding, HOSPITAL admission & discharge, HOSPITAL care, TREATMENT effectiveness, DESCRIPTIVE statistics, DISCHARGE planning, LONGITUDINAL method, MACHINE learning, COMPARATIVE studies, LENGTH of stay in hospitals, WEIGHT gain
Abstract

Objective: This study used machine learning methods to analyze data on treatment outcomes from individuals with anorexia nervosa admitted to a specialized eating disorders treatment program. Methods: Of 368 individuals with anorexia nervosa (209 adolescents and 159 adults), 160 individuals had data available for a 6‐month follow‐up analysis. Participants were treated in a 6‐day‐per‐week partial‐hospital program. Participants were assessed for eating disorder‐specific and non‐specific psychopathology. The analyses used established machine learning procedures combined in an ensemble model from support vector machine learning, random forest prediction, and the elastic net regularized regression with an exploration (training; 75%) and confirmation (test; 25%) split of the data. Results: The models predicting body mass index (BMI) at 6‐month follow‐up explained a 28.6% variance in the training set (n = 120). The model had good performance in predicting 6‐month BMI in the test dataset (n = 40), with predicted BMI significantly correlating with actual BMI (r =.51, p = 0.01). The change in BMI from admission to discharge was the most important predictor, strongly correlating with reported BMI at 6‐month follow‐up (r =.55). Behavioral variables were much less predictive of BMI outcome. Results were similar for z‐transformed BMI in the adolescent‐only group. Length of stay was most predictive of weight gain in treatment (r =.56) but did not predict longer‐term BMI. Conclusions: This study, using an agnostic ensemble machine learning approach in the largest to‐date sample of individuals with anorexia nervosa, suggests that achieving weight gain goals in treatment predicts longer‐term weight‐related outcomes. Other potential predictors, personality, mood, or eating disorder‐specific symptoms were relatively much less predictive. Public Significance: The results from this study indicate that the amount of weight gained during treatment predicts BMI 6 months after discharge from a high level of care. This suggests that patients require sufficient time in a higher level of care treatment to meet their specific weight goals and be able to maintain normal weight. [ABSTRACT FROM AUTHOR]

Published
2024
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22. Genome-wide association study identifies eight risk loci and implicates metabo-psychiatric origins for anorexia nervosa

Author

Watson, Hunna J., Yilmaz, Zeynep, Thornton, Laura M., Hübel, Christopher, Coleman, Jonathan R. I., Gaspar, Héléna A., Bryois, Julien, Hinney, Anke, Leppä, Virpi M., Mattheisen, Manuel, Medland, Sarah E., Ripke, Stephan, Yao, Shuyang, Giusti-Rodríguez, Paola, Anorexia Nervosa Genetics Initiative, Hanscombe, Ken B., Purves, Kirstin L., Eating Disorders Working Group of the Psychiatric Genomics Consortium, Adan, Roger A. H., Alfredsson, Lars, Ando, Tetsuya, Andreassen, Ole A., Baker, Jessica H., Berrettini, Wade H., Boehm, Ilka, Boni, Claudette, Perica, Vesna Boraska, Buehren, Katharina, Burghardt, Roland, Cassina, Matteo, Cichon, Sven, Clementi, Maurizio, Cone, Roger D., Courtet, Philippe, Crow, Scott, Crowley, James J., Danner, Unna N., Davis, Oliver S. P., de Zwaan, Martina, Dedoussis, George, Degortes, Daniela, DeSocio, Janiece E., Dick, Danielle M., Dikeos, Dimitris, Dina, Christian, Dmitrzak-Weglarz, Monika, Docampo, Elisa, Duncan, Laramie E., Egberts, Karin, Ehrlich, Stefan, Escaramís, Geòrgia, Esko, Tõnu, Estivill, Xavier, Farmer, Anne, Favaro, Angela, Fernández-Aranda, Fernando, Fichter, Manfred M., Fischer, Krista, Föcker, Manuel, Foretova, Lenka, Forstner, Andreas J., Forzan, Monica, Franklin, Christopher S., Gallinger, Steven, Giegling, Ina, Giuranna, Johanna, Gonidakis, Fragiskos, Gorwood, Philip, Mayora, Monica Gratacos, Guillaume, Sébastien, Guo, Yiran, Hakonarson, Hakon, Hatzikotoulas, Konstantinos, Hauser, Joanna, Hebebrand, Johannes, Helder, Sietske G., Herms, Stefan, Herpertz-Dahlmann, Beate, Herzog, Wolfgang, Huckins, Laura M., Hudson, James I., Imgart, Hartmut, Inoko, Hidetoshi, Janout, Vladimir, Jiménez-Murcia, Susana, Julià, Antonio, Kalsi, Gursharan, Kaminská, Deborah, Kaprio, Jaakko, Karhunen, Leila, Karwautz, Andreas, Kas, Martien J. H., Kennedy, James L., Keski-Rahkonen, Anna, Kiezebrink, Kirsty, Kim, Youl-Ri, Klareskog, Lars, Klump, Kelly L., Knudsen, Gun Peggy S., La Via, Maria C., Le Hellard, Stephanie, Levitan, Robert D., Li, Dong, Lilenfeld, Lisa, Lin, Bochao Danae, Lissowska, Jolanta, Luykx, Jurjen, Magistretti, Pierre J., Maj, Mario, Mannik, Katrin, Marsal, Sara, Marshall, Christian R., Mattingsdal, Morten, McDevitt, Sara, McGuffin, Peter, Metspalu, Andres, Meulenbelt, Ingrid, Micali, Nadia, Mitchell, Karen, Monteleone, Alessio Maria, Monteleone, Palmiero, Munn-Chernoff, Melissa A., Nacmias, Benedetta, Navratilova, Marie, Ntalla, Ioanna, O’Toole, Julie K., Ophoff, Roel A., Padyukov, Leonid, Palotie, Aarno, Pantel, Jacques, Papezova, Hana, Pinto, Dalila, Rabionet, Raquel, Raevuori, Anu, Ramoz, Nicolas, Reichborn-Kjennerud, Ted, Ricca, Valdo, Ripatti, Samuli, Ritschel, Franziska, Roberts, Marion, Rotondo, Alessandro, Rujescu, Dan, Rybakowski, Filip, Santonastaso, Paolo, Scherag, André, Scherer, Stephen W., Schmidt, Ulrike, Schork, Nicholas J., Schosser, Alexandra, Seitz, Jochen, Slachtova, Lenka, Slagboom, P. Eline, Slof-Op ‘t Landt, Margarita C. T., Slopien, Agnieszka, Sorbi, Sandro, Świątkowska, Beata, Szatkiewicz, Jin P., Tachmazidou, Ioanna, Tenconi, Elena, Tortorella, Alfonso, Tozzi, Federica, Treasure, Janet, Tsitsika, Artemis, Tyszkiewicz-Nwafor, Marta, Tziouvas, Konstantinos, van Elburg, Annemarie A., van Furth, Eric F., Wagner, Gudrun, Walton, Esther, Widen, Elisabeth, Zeggini, Eleftheria, Zerwas, Stephanie, Zipfel, Stephan, Bergen, Andrew W., Boden, Joseph M., Brandt, Harry, Crawford, Steven, Halmi, Katherine A., Horwood, L. John, Johnson, Craig, Kaplan, Allan S., Kaye, Walter H., Mitchell, James E., Olsen, Catherine M., Pearson, John F., Pedersen, Nancy L., Strober, Michael, Werge, Thomas, Whiteman, David C., Woodside, D. Blake, Stuber, Garret D., Gordon, Scott, Grove, Jakob, Henders, Anjali K., Juréus, Anders, Kirk, Katherine M., Larsen, Janne T., Parker, Richard, Petersen, Liselotte, Jordan, Jennifer, Kennedy, Martin, Montgomery, Grant W., Wade, Tracey D., Birgegård, Andreas, Lichtenstein, Paul, Norring, Claes, Landén, Mikael, Martin, Nicholas G., Mortensen, Preben Bo, Sullivan, Patrick F., Breen, Gerome, and Bulik, Cynthia M.

Published
2019
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25. Elevated interoceptive deficits in individuals with eating disorders and self‐injurious thoughts and behaviors: A replication and extension.

Author

Velkoff, Elizabeth A., Perkins, Natalie M., Dodd, Dorian R., Brown, Tiffany A., Kaye, Walter H., and Wierenga, Christina E.

Subjects
INTEROCEPTION, SELF-injurious behavior, EATING disorders, ATTEMPTED suicide, SUICIDAL ideation
Abstract

Introduction: People with eating disorders (EDs) frequently report self‐injurious thoughts and behaviors (SITBs). We aimed to replicate and extend findings demonstrating greater interoceptive deficits according to SITB severity. We predicted that interoceptive deficits would be greater among people with versus without lifetime SITBs and among those with multiple suicide attempts compared with single attempts or nonsuicidal self‐injury. We also predicted that interoception would be increasingly impaired with greater current suicidality severity. Method: Adults (N = 118) seeking ED treatment reported current and lifetime SITBs upon admission to treatment. We used planned contrasts to compare interoceptive deficits (self‐reported using the Eating Disorders Inventory) by SITB and current suicidality groups (assessed by self‐report and clinical interview). Results: Interoceptive deficits were greater among people with any SITB history compared to those without. People with multiple suicide attempts did not differ in interoceptive deficits from those with single attempts or only nonsuicidal self‐injury. Interoceptive deficits were elevated among those with any current suicidality compared to those with no suicidal symptoms; interoceptive deficits did not differ according to severity of suicidality. Conclusion: Among those with EDs, interoceptive deficits are elevated among those with concurrent SITBs. Interventions aimed at improving interoception may reduce the risk for SITBs. [ABSTRACT FROM AUTHOR]

Published
2024
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26. Expanding considerations for treating avoidant/restrictive food intake disorder at a higher level of care.

Author

Richson, Brianne N., Deville, Danielle C., Wierenga, Christina E., Kaye, Walter H., and Ramirez, Ana L.

Subjects
DIALECTICAL behavior therapy, FOOD consumption, EXECUTIVE function, PEDIATRIC therapy, SENSORIMOTOR integration
Abstract

Existing descriptions of the treatment of avoidant/restrictive food intake disorder (ARFID) at higher levels of care (HLOC) for eating disorders are limited, despite HLOC settings frequently serving patients with ARFID. The purpose of this commentary is to expand on the preliminary literature that describes pediatric ARFID treatment at HLOC by describing two specific components of our approach to treating pediatric ARFID that may not yet have traction in the current literature. Specifically, we highlight the utility of (1) treatment accommodations that appropriately account for patients' neurodevelopmental needs (e.g., executive functioning, sensory processing) and (2) the adjunctive use of Dialectical Behavior Therapy (DBT) elements within family-based pediatric ARFID treatment. We also describe necessary future directions for research in these domains to clarify if incorporating these considerations and approaches into pediatric ARFID treatment at HLOC does indeed improve treatment outcomes. [ABSTRACT FROM AUTHOR]

Published
2024
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29. EATING DISORDERS: PART 2 Higher Levels of Care for Eating Disorders: A Practical Guide

Author

Anderson, Leslie K., Simpson, Courtney, and Kaye, Walter H.

Subjects
Comorbidity -- Care and treatment, Compulsive eating -- Care and treatment, Psychology, Pathological, Evidence-based medicine, Health, Psychology and mental health
Abstract

Eating disorders (ED) are associated with significant comorbid psychopathology and the most extensive medical complications of any psychiatric disorder. Disordered behaviors that present across diagnoses (eg, restriction, binge eating, compensatory [...]

Published
2019

31. Using clinical cutoff scores on the eating disorder examination-questionnaire to evaluate eating disorder symptoms during and after naturalistic intensive treatment.

Author

Velkoff, Elizabeth A., Brown, Tiffany A., Kaye, Walter H., and Wierenga, Christina E.

Subjects
RESEARCH methodology evaluation, RESEARCH methodology, SELF-evaluation, PSYCHOMETRICS, TREATMENT effectiveness, QUESTIONNAIRES, DESCRIPTIVE statistics, LONGITUDINAL method, DISCHARGE planning, EVALUATION
Abstract

Clinical cutoff scores for self-report measures provide a means of evaluating clinically significant pathology during and after treatment. A cutoff of 2.8 on the Eating Disorder Examination-Questionnaire (EDE-Q) has been recommended to screen for eating disorders (ED). We used this cutoff to assess ED symptoms in adolescents (n = 444) and adults (n = 592) through ED treatment and follow-up. Most patients scored above 2.8 at intake (adolescents 67%, M = 3.21; adults 78%, M = 4.20) and below 2.8 at discharge (adolescents 65%, M = 1.87; adults 66%, M = 2.67), with gains often maintained through follow-up (40% of adolescents and 35% of adults at 12-month follow-up). EDE-Q scores were higher in adults than adolescents and in patients with binge/purge disorders. Results suggest a cutoff of 2.8 on the EDE-Q effectively tracks ED symptom improvement through treatment and discharge. This supports the need for the development of culture-specific and empirically developed clinical cutoffs and their widespread use to evaluate program effectiveness. [ABSTRACT FROM AUTHOR]

Published
2023
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33. Pharmacological Management of Treatment-Resistant Anorexia Nervosa

Author

Trunko, Mary Ellen, Frank, Guido K.W., Schwartz, Terry A., and Kaye, Walter H.

Subjects
Mortality, Anorexia nervosa -- Prognosis, Evidence-based medicine -- Health aspects, Weight loss -- Prognosis, Health, Psychology and mental health
Abstract

Anorexia nervosa (AN) is a severe psychiatric disorder characterized by restricted eating, significant weight loss, and a profound fear of weight gain. AN and the related disorder, bulimia nervosa, have [...]

Published
2022

34. The role of leptin, melanocortin, and neurotrophin system genes on body weight in anorexia nervosa and bulimia nervosa

Author

Yilmaz, Zeynep, Kaplan, Allan S., Tiwari, Arun K., Levitan, Robert D., Piran, Sara, Bergen, Andrew W., Kaye, Walter H., Hakonarson, Hakon, Wang, Kai, Berrettini, Wade H., Brandt, Harry A., Bulik, Cynthia M., Crawford, Steven, Crow, Scott, Fichter, Manfred M., Halmi, Katherine A., Johnson, Craig L., Keel, Pamela K., Klump, Kelly L., Magistretti, Pierre, Mitchell, James E., Strober, Michael, Thornton, Laura M., Treasure, Janet, Woodside, D. Blake, Knight, Joanne, and Kennedy, James L.

Published
2014
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39. Factors associated with recovery from anorexia nervosa

Author

Zerwas, Stephanie, Lund, Brian C., Von Holle, Ann, Thornton, Laura M., Berrettini, Wade H., Brandt, Harry, Crawford, Steven, Fichter, Manfred M., Halmi, Katherine A., Johnson, Craig, Kaplan, Allan S., La Via, Maria, Mitchell, James, Rotondo, Alessandro, Strober, Michael, Woodside, D. Blake, Kaye, Walter H., and Bulik, Cynthia M.

Published
2013
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44. Associations of suicide risk with emotional reactivity, dysregulation, and eating disorder treatment outcomes.

Author

Denning, Dominic M., Perry, Taylor R., Reilly, Erin E., Berner, Laura A., Velkoff, Elizabeth A., Kaye, Walter H., Wierenga, Christina E., and Brown, Tiffany A.

Subjects
EATING disorders, SUICIDE, TREATMENT effectiveness, ATTEMPTED suicide, SUICIDE victims, SUICIDE risk factors
Abstract

Introduction: Emotional processes play a role in both suicide risk and eating disorders (EDs), which are often comorbid. However, limited research has explored how emotional processes relate to suicide risk in EDs and the prognostic value of suicide risk for ED treatment. Thus, the current study examined associations between emotion dysregulation and reactivity with suicide risk in patients with EDs, and determined if suicide risk predicts ED treatment outcomes. Methods: Participants (n = 201) were adults in an ED partial hospitalization program who completed measures at admission, 1‐month post‐admission, and discharge. Results: When controlling for depressive symptoms, limited access to adaptive emotion regulation strategies, difficulties engaging in goal‐oriented behaviors, and engaging in impulsive behavior when experiencing negative emotions (i.e., emotion dysregulation) were associated with suicide attempt frequency. Depressive symptoms were associated with suicide risk severity, while emotion dysregulation and reactivity were not. Importantly, patients with elevated suicide risk at admission improved comparably to other risk categories across treatment, despite presenting with greater ED symptoms at admission. Conclusion: Emotion dysregulation and depression are salient factors when examining suicide risk in patients with EDs. Suicide risk and attempt history may not negatively impact ED treatment outcomes when using emotion‐focused treatment. [ABSTRACT FROM AUTHOR]

Published
2022
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45. Habitual starvation and provocative behaviors: Two potential routes to extreme suicidal behavior in anorexia nervosa

Author

Selby, Edward A., Smith, April R., Bulik, Cynthia M., Olmsted, Marion P., Thornton, Laura, McFarlane, Traci L., Berrettini, Wade H., Brandt, Harry A., Crawford, Steve, Fichter, Manfred M., Halmi, Katherine A., Jacoby, Georg E., Johnson, Craig L., Jones, Ian, Kaplan, Allan S., Mitchell, James E., Nutzinger, Detlev O., Strober, Michael, Treasure, Janet, Woodside, D. Blake, Kaye, Walter H., and Joiner, Thomas E., Jr.

Published
2010
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46. Childhood anxiety associated with low BMI in women with Anorexia Nervosa

Author

Dellava, Jocilyn E., Thornton, Laura M., Hamer, Robert M., Strober, Michael, Plotnicov, Katherine, Klump, Kelly L., Brandt, Harry, Crawford, Steve, Fichter, Manfred M., Halmi, Katherine A., Jones, Ian, Johnson, Craig, Kaplan, Allan S., LaVia, Maria, Mitchell, James, Rotondo, Alessandro, Treasure, Janet, Woodside, D. Blake, Berrettini, Wade H., Kaye, Walter H., and Bulik, Cynthia M.

Published
2010
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49. Altered Reinforcement Learning from Reward and Punishment in Anorexia Nervosa: Evidence from Computational Modeling.

Author

Wierenga, Christina E., Reilly, Erin, Bischoff-Grethe, Amanda, Kaye, Walter H., and Brown, Gregory G.

Subjects
REWARD (Psychology), REINFORCEMENT learning, PUNISHMENT (Psychology), ANOREXIA nervosa, WEIGHT gain, CLASSIFICATION of mental disorders
Abstract

Objectives: Anorexia nervosa (AN) is associated with altered sensitivity to reward and punishment. Few studies have investigated whether this results in aberrant learning. The ability to learn from rewarding and aversive experiences is essential for flexibly adapting to changing environments, yet individuals with AN tend to demonstrate cognitive inflexibility, difficulty set-shifting and altered decision-making. Deficient reinforcement learning may contribute to repeated engagement in maladaptive behavior. Methods: This study investigated learning in AN using a probabilistic associative learning task that separated learning of stimuli via reward from learning via punishment. Forty-two individuals with Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 restricting-type AN were compared to 38 healthy controls (HCs). We applied computational models of reinforcement learning to assess group differences in learning, thought to be driven by violations in expectations, or prediction errors (PEs). Linear regression analyses examined whether learning parameters predicted BMI at discharge. Results: AN had lower learning rates than HC following both positive and negative PE (p < .02), and were less likely to exploit what they had learned. Negative PE on punishment trials predicted lower discharge BMI (p < .001), suggesting individuals with more negative expectancies about avoiding punishment had the poorest outcome. Conclusions: This is the first study to show lower rates of learning in AN following both positive and negative outcomes, with worse punishment learning predicting less weight gain. An inability to modify expectations about avoiding punishment might explain persistence of restricted eating despite negative consequences, and suggests that treatments that modify negative expectancy might be effective in reducing food avoidance in AN. [ABSTRACT FROM AUTHOR]

Published
2022
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