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BACKGROUND: Efforts to examine alternative classifications (e.g., personality) of anorexia nervosa (AN) using empirical techniques are crucial to elucidate diverse symptom presentations, personality traits, and psychiatric comorbidities. AIMS: The purpose of this study was to use an empirical approach (mixture modeling) to test an alternative classification of AN as categorical, dimensional, or hybrid categorical–dimensional construct based on the co-occurrence of personality psychopathology and eating disorder clinical presentation. METHODS: Patients with AN ( N = 194) completed interviews and questionnaires at treatment admission and 3-month follow-up. Mixture modeling was used to test whether indicators best classified AN as categorical, dimensional, or hybrid. RESULTS: A four-latent class, one-latent dimension mixture model that was variant across groups provided the best fit to the data. Results suggest that all classes were characterized by low self-esteem and self-harming and suicidality tendencies. Individuals assigned to Latent Class 2 (LC2; n = 21) had a greater tendency toward being impulsive and easily angered and having difficulties controlling anger compared with those in LC1 ( n = 84) and LC3 ( n = 66). Moreover, individuals assigned to LC1 and LC3 were more likely to have a poor outcome from intensive treatment compared with those in LC4 ( n = 21). Findings indicate that the dimensional aspect within each class measured frequency of specific eating disorder behaviors but did not predict treatment outcomes. CONCLUSIONS: These results emphasize the complexity of AN and the importance of considering how facets of clinical presentation beyond eating disorder behaviors may have different treatment and prognostic implications.

The Eating Disorder Examination Questionnaire (EDE-Q; Fairburn & Cooper, 1993; Fairburn, Cooper, & O’Connor, 2008) is a well-established self-report instrument that measures eating disorder behaviors and attitudes, and is derived from the Eating Disorder Examination (EDE) interview (Fairburn & Cooper, 1993; Fairburn et al., 2008). The EDE-Q is relatively brief and cost-efficient, and is used for research and clinical purposes. Normative data are needed for appropriate analysis and interpretation of EDE-Q scores. Additionally, normative data provides a baseline distribution in a representative sample of individuals with eating disorders and establishes a baseline for comparison to healthy controls and individuals who have recovered from an eating disorder. Currently, normative data exists in a myriad of adult populations such as undergraduate students (Darcy, Hardy, Lock, Hill, & Peebles, 2013; Keane, Clarke, McGrath, Farrelly, & MacHale, 2017; Kelly, Cotter, & Mazzeo, 2012; Lavender, De Young, & Anderson, 2010; Luce & Crowther, 1999; Luce, Crowther, & Pole, 2008; Nakai et al., 2014; Quick & Byrd-Bredbenner, 2013; Reas, Overas, & Ro, 2012; Ro, Reas, & Lask, 2010; Villarroel, Penelo, Portell, & Raich, 2011), community samples (Hilbert, de Zwaan, & Braehler, 2012; Machado et al., 2014; Mond, Hay, Rodgers, & Owen, 2006; Mond, Hay, Rodgers, Owen, & Beumont, 2004), eating disorder (ED) samples (Brewin, Baggott, Dugard, & Arcelus, 2014; Dahlgren, Stedal, & Ro, 2017; Jennings & Phillips, 2017; Smith et al., 2017), and both ED and community samples (Aardoom, Dingemans, Slof Op’t Landt, & Van Furth, 2012; Welch, Birgegard, Parling, & Ghaderi, 2011). Few studies have examined normative data in adolescent populations. Normative EDE-Q data are available for healthy adolescent girls in the United Kingdom (Carter, Stewart, & Fairburn, 2001) and Portugal (Machado et al., 2014), and healthy adolescent boys and girls in Australia (Mond et al., 2014), Malaysia (Musa et al., 2016), and Mexico (Penelo, Negrete, Portell, & Raich, 2013). One Swedish study (Mantilla & Birgegard, 2016) reported norms on clinical and healthy adolescents using a 14-day time frame version of the EDE-Q, which had been specifically modified for adolescents (Carter et al., 2001). To the knowledge of these researchers, despite increased research and clinical use of the EDE-Q in adolescent populations, normative data in a clinical sample in the United States (U.S.) has not been published. Thus, the purpose of the present study was to provide EDE-Q norms for a sample of adolescent females diagnosed with anorexia nervosa (AN) admitted to inpatient treatment for an eating disorder.

BACKGROUND: Identifying distinct trajectories of change in body weight during inpatient treatment for anorexia nervosa (AN) may provide knowledge about the process of weight restoration and may help detect optimal body weight response patterns among individuals who are at risk for not achieving weight restoration or leaving treatment prematurely. OBJECTIVE: This study explored the extent to which distinct trajectories of change in body weight existed among individuals during inpatient treatment for AN. DESIGN: Group-based trajectory modeling was used to identify distinct trajectories of change in body weight among 500 individuals receiving inpatient treatment for AN. RESULTS: Four distinct trajectories were identified: weight gain ( n = 197), treatment resistant ( n = 177), weight plateau ( n = 82), and weight fluctuate ( n = 44). CONCLUSION: Clinically, it is important to consider the heterogeneity of changes in body weight during inpatient treatment to help guide interventions and outcomes.

BACKGROUND: Weight assessment is a key component of nursing care for individuals with the acute illness of anorexia nervosa (AN). However, there is little data to guide protocols and procedures regarding weight assessment. OBJECTIVE: To describe institutional practices regarding weight assessment of individuals during acute illness of AN. DESIGN: Treatment facilities ( N = 24) completed a survey about written protocols and procedures regarding weight assessment and disclosure of weight to patients. RESULTS: The majority of facilities ( n = 22; 92%) have written protocols for weight assessment. Weight assessments occurred mostly in the morning ( n = 23; 95.8%), in hospital gowns ( n = 21; 87.5%), and after voiding ( n = 14; 58.3%). Respondents described mixed practices for disclosing weight to patients. CONCLUSION: Results indicate widespread variability in weight assessment and disclosure of weight. Further research is necessary to help develop evidence-based guidelines about weighing practices during acute illness for individuals with AN.

BACKGROUND Desired weight is an indicator of illness severity in youth with anorexia nervosa (AN), but its impact on eating disorder symptoms over time and in adults is unknown. This study examined longitudinal associations between two desired weight constructs (desired weight percentage, weight difference percentage) and eating disorder severity and body mass index (BMI) in patients aged 16-62 years old with AN presenting for inpatient or day hospital treatment. METHOD Participants (N = 160) completed the Eating Disorder Examination and measures of height and weight at treatment admission, discharge, and 3, 6, and 12 months post-discharge. Desired weight percentage was calculated as [desired BMI(desired weight in kg/height in meters2 )/healthy BMI] × 100. weight difference percentage was calculated as [(actual weight-desired weight)/actual weight] × 100. RESULTS At admission, participants were approximately 78.6% of a healthy BMI and desired to be 81% of a healthy BMI. During the year following treatment, participants were 89% of a healthy BMI, but wanted to be 86% of a healthy BMI. Individuals with lower desired weight percentage (wanting to be a lower percentage of a healthy BMI) or higher weight difference percentage (wanting to lose a larger percentage of weight) at treatment admission endorsed greater eating disorder severity across time. Additionally, individuals with higher desired weight percentage or weight difference percentage had higher BMIs at intake, and greater increases in BMI over time. DISCUSSION Results highlight that desired weight constructs represent correlates of illness severity in AN and may inform an individual's likely weight trajectory during and after treatment.

An exploratory factor analysis on the Eating Disorder Examination-Questionnaire (EDE-Q) is presented for a clinical sample of women with anorexia nervosa. THE EDE-Q was completed by 169 participants after admission to an inpatient unit for eating disorders. Results of the current study did not support the four-factor model presented by the EDE-Q. A new four-factor solution was obtained with two factors showing similarity to the Restraint and Eating Concern subscales of the original model. The Shape and Weight Concern items primarily loaded together on one factor, along with preoccupation with food and fear of losing control over eating, two Eating Concern items. Finally, an appearance factor was obtained that supports the results of prior research. [ Journal of Psychosocial Nursing and Mental Health Services, 56 (5), 33–39.].

Using a nursing theoretical framework to understand, elucidate, and propose nursing research is fundamental to knowledge development. This article presents the Roy Adaptation Model as a theoretical framework to better understand individuals with anorexia nervosa during acute treatment, and the role of nursing assessments and interventions in the promotion of weight restoration. Nursing assessments and interventions situated within the Roy Adaptation Model take into consideration how weight restoration does not occur in isolation but rather reflects an adaptive process within external and internal environments, and has the potential for more holistic care.

Normative data on the Eating Disorder Examination Questionnaire (EDE-Q) for a clinical sample of males in the United States are presented. Thirty-eight males completed the EDE-Q at time of admission to an inpatient unit for eating disorders. The majority of males were diagnosed with unspecified eating disorder (73.7%, n = 28). Mean age at time of admission was 24.4 years (SD = 12.6), mean body mass index at time of admission was 21.5 kg/m2 (SD = 9.5), and mean length of stay was 13.6 days (SD = 9.3). Mean scores, standard deviations, and percentile ranks for the global and subscale scores are provided. Although the prevalence of eating disorders remains lower among males compared to females, body dissatisfaction and eating disorder psychopathology are fairly common among males.