1,369 results on '"Kaye, Walter H."'
Search Results
2. Expanding considerations for treating avoidant/restrictive food intake disorder at a higher level of care
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Richson, Brianne N., Deville, Danielle C., Wierenga, Christina E., Kaye, Walter H., and Ramirez, Ana L.
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- 2024
- Full Text
- View/download PDF
3. State-specific alterations in the neural computations underlying inhibitory control in women remitted from bulimia nervosa
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Berner, Laura A, Harlé, Katia M, Simmons, Alan N, Yu, Angela, Paulus, Martin P, Bischoff-Grethe, Amanda, Wierenga, Christina E, Bailer, Ursula F, and Kaye, Walter H
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Nutrition ,Clinical Research ,Neurosciences ,Eating Disorders ,Mental Health ,Brain Disorders ,Biological Sciences ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Psychiatry - Abstract
The neurocomputational processes underlying bulimia nervosa and its primary symptoms, out-of-control overeating and purging, are poorly understood. Research suggests that the brains of healthy individuals form a dynamic internal model to predict whether control is needed in each moment. This study tested the hypothesis that this computational process of inhibitory control is abnormally affected by metabolic state (being fasted or fed) in bulimia nervosa. A Bayesian ideal observer model was fit to behavioral data acquired from 22 women remitted from bulimia nervosa and 20 group-matched controls who completed a stop-signal task during two counterbalanced functional MRI sessions, one after a 16 h fast and one after a meal. This model estimates participants' trial-by-trial updating of the probability of a stop signal based on their experienced trial history. Neural analyses focused on control-related Bayesian prediction errors, which quantify the direction and degree of "surprise" an individual experiences on any given trial. Regardless of group, metabolic state did not affect behavioral performance on the task. However, metabolic state modulated group differences in neural activation. In the fed state, women remitted from bulimia nervosa had attenuated prediction-error-dependent activation in the left dorsal caudate. This fed-state activation was lower among women with more frequent past binge eating and self-induced vomiting. When they are in a fed state, individuals with bulimia nervosa may not effectively process unexpected information needed to engage inhibitory control. This may explain the difficulties these individuals have stopping eating after it begins.
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- 2023
4. Impaired belief updating and devaluation in adult women with bulimia nervosa
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Berner, Laura A, Fiore, Vincenzo G, Chen, Joanna Y, Krueger, Angeline, Kaye, Walter H, Viranda, Thalia, and de Wit, Sanne
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Biological Psychology ,Biomedical and Clinical Sciences ,Psychology ,Mental Health ,Behavioral and Social Science ,Nutrition ,Brain Disorders ,Clinical Research ,Eating Disorders ,Adult ,Female ,Humans ,Bulimia Nervosa ,Bayes Theorem ,Bulimia ,Binge-Eating Disorder ,Feeding and Eating Disorders ,Clinical Sciences ,Public Health and Health Services ,Clinical sciences ,Neurosciences ,Biological psychology - Abstract
Recent models of bulimia nervosa (BN) propose that binge-purge episodes ultimately become automatic in response to cues and insensitive to negative outcomes. Here, we examined whether women with BN show alterations in instrumental learning and devaluation sensitivity using traditional and computational modeling analyses of behavioral data. Adult women with BN (n = 30) and group-matched healthy controls (n = 31) completed a task in which they first learned stimulus-response-outcome associations. Then, participants were required to repeatedly adjust their responses in a "baseline test", when different sets of stimuli were explicitly devalued, and in a "slips-of-action test", when outcomes instead of stimuli were devalued. The BN group showed intact behavioral sensitivity to outcome devaluation during the slips-of-action test, but showed difficulty overriding previously learned stimulus-response associations on the baseline test. Results from a Bayesian learner model indicated that this impaired performance could be accounted for by a slower pace of belief updating when a new set of previously learned responses had to be inhibited (p = 0.036). Worse performance and a slower belief update in the baseline test were each associated with more frequent binge eating (p = 0.012) and purging (p = 0.002). Our findings suggest that BN diagnosis and severity are associated with deficits in flexibly updating beliefs to withhold previously learned responses to cues. Additional research is needed to determine whether this impaired ability to adjust behavior is responsible for maintaining automatic and persistent binge eating and purging in response to internal and environmental cues.
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- 2023
5. Research in eating disorders: the misunderstanding of supposing serious mental illnesses as a niche specialty
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Marzola, Enrica, Panero, Matteo, Longo, Paola, Martini, Matteo, Fernàndez-Aranda, Fernando, Kaye, Walter H, and Abbate-Daga, Giovanni
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Biomedical and Clinical Sciences ,Clinical and Health Psychology ,Clinical Sciences ,Nutrition and Dietetics ,Psychology ,Mental Health ,Schizophrenia ,Brain Disorders ,Serious Mental Illness ,Mental health ,Good Health and Well Being ,Humans ,Journal Impact Factor ,Bibliometrics ,Feeding and Eating Disorders ,Anorexia nervosa ,Bulimia nervosa ,Binge eating disorder ,Bibliometry ,Bradford's law ,Bradford’s law ,Clinical Psychology ,Clinical sciences ,Nutrition and dietetics ,Clinical and health psychology - Abstract
PurposeEating disorders (EDs) are mental illnesses with severe consequences and high mortality rates. Notwithstanding, EDs are considered a niche specialty making it often difficult for researchers to publish in high-impact journals. Subsequently, research on EDs receives less funding than other fields of psychiatry potentially slowing treatment progress. This study aimed to compare research vitality between EDs and schizophrenia focusing on: number and type of publications; top-cited articles; geographical distribution of top-ten publishing countries; journal distribution of scientific production as measured by bibliometric analysis; funded research and collaborations.MethodsWe used the Scopus database, then we adopted the Bibliometrix R-package software with the web interface app Biblioshiny. We included in the analyses 1,916 papers on EDs and 6491 on schizophrenia.ResultsThe ED field published three times less than schizophrenia in top-ranking journals - with letters and notes particularly lacking-notwithstanding a comparable number of papers published per author. Only 50% of top-cited articles focused on EDs and a smaller pool of journals available for ED research (i.e., Zones 1 and 2 according to Bradford's law) emerged; journals publishing on EDs showed an overall lower rank compared to the schizophrenia field. Schizophrenia research was more geographically distributed and more funded; in contrast, a comparable collaboration index was found between the fields.ConclusionThese data show that research on EDs is currently marginalized and top-rank journals are seldom achievable by researchers in EDs. Such difficulties in research dissemination entail potentially serious repercussions on clinical advancements.Level of evidenceLevel V: opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.
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- 2022
6. Integrating evidence-based PTSD treatment into intensive eating disorders treatment: a preliminary investigation
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Claudat, Kimberly, Reilly, Erin E, Convertino, Alexandra D, Trim, Julie, Cusack, Anne, and Kaye, Walter H
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Clinical and Health Psychology ,Psychology ,Clinical Trials and Supportive Activities ,Rare Diseases ,Post-Traumatic Stress Disorder (PTSD) ,Brain Disorders ,Anxiety Disorders ,Mental Health ,Behavioral and Social Science ,Clinical Research ,Nutrition ,Eating Disorders ,Evaluation of treatments and therapeutic interventions ,6.6 Psychological and behavioural ,Mental health ,Adult ,Male ,Humans ,Female ,Stress Disorders ,Post-Traumatic ,Cognitive Behavioral Therapy ,Comorbidity ,Feeding and Eating Disorders ,Treatment Outcome ,Eating disorders ,Treatment ,Post-traumatic stress disorder ,Partial-hospital program ,Co-occurring disorders ,Clinical Sciences ,Clinical Psychology ,Clinical sciences ,Nutrition and dietetics ,Clinical and health psychology - Abstract
PurposeGiven data suggesting common co-occurrence and worse outcomes for individuals with eating disorders (EDs) and post-traumatic stress disorder (PTSD), it is critical to identify integrated treatment approaches for this group of patients. Past work has explored the feasibility and initial efficacy of intervention approaches that draw on evidence-based treatments for both EDs and PTSD; however, this work remains limited in scope. In the current study, we explored the feasibility and naturalistic outcomes of PTSD treatment delivered within the context of intensive ED treatment.MethodParticipants were 57 adult men and women with DSM-5 EDs and comorbid PTSD who completed a course of either Prolonged Exposure (PE; n = 22) or Cognitive Processing Therapy (CPT; n = 35) (Msessions = 10.40; SD = 5.13) and weekly validated measurements of clinical symptoms while enrolled in ED programming.ResultsMulti-level models for PTSD symptoms indicated a significant linear effect of time, such that participants demonstrated significant decreases over time in PTSD symptoms, regardless of treatment modality.ConclusionOur preliminary investigation provides support for the feasibility and efficacy of an integrated approach to treating EDs and PTSD. It is critical for future work to undertake randomized tests of this integrated approach using large, heterogeneous samples.Level of evidenceLevel IV, multiple time series with intervention.
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- 2022
7. Altered Reinforcement Learning from Reward and Punishment in Anorexia Nervosa: Evidence from Computational Modeling
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Wierenga, Christina E, Reilly, Erin, Bischoff-Grethe, Amanda, Kaye, Walter H, and Brown, Gregory G
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Eating Disorders ,Anorexia ,Clinical Research ,Brain Disorders ,Behavioral and Social Science ,Basic Behavioral and Social Science ,Nutrition ,Mental Health ,Mental health ,Good Health and Well Being ,Humans ,Punishment ,Anorexia Nervosa ,Reward ,Computer Simulation ,Affect ,Eating disorders ,prediction error ,operant learning ,decision-making ,cognition ,probabilistic associative learning ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Experimental Psychology - Abstract
ObjectivesAnorexia 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.MethodsThis 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.ResultsAN had lower learning rates than HC following both positive and negative PE (p
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- 2022
8. Psilocybin therapy for females with anorexia nervosa: a phase 1, open-label feasibility study
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Peck, Stephanie Knatz, Shao, Samantha, Gruen, Tessa, Yang, Kevin, Babakanian, Alexandra, Trim, Julie, Finn, Daphna M., and Kaye, Walter H.
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- 2023
- Full Text
- View/download PDF
9. State-specific alterations in the neural computations underlying inhibitory control in women remitted from bulimia nervosa
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Berner, Laura A., Harlé, Katia M., Simmons, Alan N., Yu, Angela, Paulus, Martin P., Bischoff-Grethe, Amanda, Wierenga, Christina E., Bailer, Ursula F., and Kaye, Walter H.
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- 2023
- Full Text
- View/download PDF
10. Evaluating the use of lamotrigine to reduce mood lability and impulsive behaviors in adults with chronic and severe eating disorders
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Reilly, Erin E, Berner, Laura A, Trunko, Mary Ellen, Schwartz, Terry, Anderson, Leslie K, Krueger, Angeline, Yu, Xinze, Chen, Joanna Y, Cusack, Anne, Nakamura, Tiffany, and Kaye, Walter H
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Clinical and Health Psychology ,Social and Personality Psychology ,Psychology ,Mind and Body ,Behavioral and Social Science ,Brain Disorders ,Basic Behavioral and Social Science ,Mental Health ,Depression ,Clinical Research ,Mental health ,Adult ,Affective Symptoms ,Borderline Personality Disorder ,Feeding and Eating Disorders ,Female ,Humans ,Impulsive Behavior ,Lamotrigine ,Bulimia nervosa ,Anorexia nervosa ,Emotion dysregulation ,Impulsivity ,Clinical Sciences ,Clinical Psychology ,Clinical sciences ,Nutrition and dietetics ,Clinical and health psychology - Abstract
BackgroundGold-standard psychological and pharmacological treatments for bulimic-spectrum eating disorders only result in remission for around 50% of patients; patients with affective lability and impulsivity represent a subgroup with particularly poor outcomes. Both dialectical behavior therapy (DBT), a treatment for emotion dysregulation, and lamotrigine, a mood stabilizer, have demonstrated promise for targeting affective lability and impulsivity; however, data exploring the combination of these interventions remain limited.ObjectiveWe followed a group of women with recurrent dysregulated eating behaviors (N = 62) throughout intensive DBT treatment and compared the symptom trajectory of those prescribed lamotrigine (n = 28) and those who were not (n = 34).MethodParticipants completed surveys every 2 weeks throughout treatment.ResultsGroup analyses suggested that all participants self-reported decreases in emotional reactivity, negative urgency, and symptoms of borderline personality disorder (BPD). The lamotrigine group reported greater elevations in BPD symptoms at baseline, but demonstrated steeper decreases in emotion and behavioral dysregulation than the non-matched comparison group. Within-subject analyses suggested that within the lamotrigine group, subjects reported greater decreases in symptoms following prescription of lamotrigine.ConclusionsFindings provide initial data suggesting that lamotrigine could be useful as an adjunctive treatment for patients with affective lability and impulsivity.Level of evidenceIV, time series without randomization.
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- 2022
11. Changes in cognitive and behavioral control after lamotrigine and intensive dialectical behavioral therapy for severe, multi-impulsive bulimia nervosa: an fMRI case study
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Berner, Laura A, Reilly, Erin E, Yu, Xinze, Krueger, Angeline, Trunko, Mary Ellen, Anderson, Leslie K, Chen, Joanna, Simmons, Alan N, and Kaye, Walter H
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Biological Psychology ,Psychology ,Clinical Trials and Supportive Activities ,Brain Disorders ,Neurosciences ,Mind and Body ,Mental Health ,Behavioral and Social Science ,Biomedical Imaging ,Clinical Research ,Nutrition ,Eating Disorders ,Adult ,Behavior Control ,Behavior Therapy ,Bulimia Nervosa ,Cognition ,Female ,Humans ,Impulsive Behavior ,Lamotrigine ,Magnetic Resonance Imaging ,Binge eating ,Purging ,Bulimia nervosa ,Cognitive control ,Dialectical behavior therapy ,Clinical Sciences ,Clinical Psychology ,Clinical sciences ,Nutrition and dietetics ,Clinical and health psychology - Abstract
PurposeAdults with bulimia nervosa (BN) and co-occurring emotional dysregulation and multiple impulsive behaviors are less responsive to existing interventions. Initial data suggest that the combination of Dialectical Behavior Therapy (DBT) and a mood stabilizer, lamotrigine, significantly reduces symptoms of affective and behavioral dysregulation in these patients. Identifying candidate neurobiological mechanisms of change for this novel treatment combination may help guide future randomized controlled trials and inform new and targeted treatment development. Here, we examined neurocognitive and symptom changes in a female patient with BN and severe affective and behavioral dysregulation who received DBT and lamotrigine.MethodsGo/no-go task performance data and resting-state functional MRI scans were acquired before the initiation of lamotrigine (after 6 weeks in an intensive DBT program), and again after reaching and maintaining a stable dose of lamotrigine. The patient completed a battery of symptom measures biweekly for 18 weeks over the course of treatment.ResultsAfter lamotrigine initiation, the patient made fewer errors on a response inhibition task and showed increased and new connectivity within frontoparietal and frontolimbic networks involved in behavioral and affective control. Accompanying this symptom improvement, the patient reported marked reductions in bulimic symptoms, behavioral dysregulation, and reactivity to negative affect, along with increases in DBT skills use.ConclusionImproved response inhibition and cognitive control network connectivity should be further investigated as neurocognitive mechanisms of change with combined DBT and lamotrigine for eating disorders. Longitudinal, controlled trials integrating neuroimaging and symptom measures are needed to fully evaluate the effects of this treatment.Level of evidenceIV: Evidence obtained from multiple time series with or without the intervention, such as case studies.
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- 2022
12. Dissecting the Shared Genetic Architecture of Suicide Attempt, Psychiatric Disorders, and Known Risk Factors.
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Mullins, Niamh, Kang, JooEun, Campos, Adrian I, Coleman, Jonathan RI, Edwards, Alexis C, Galfalvy, Hanga, Levey, Daniel F, Lori, Adriana, Shabalin, Andrey, Starnawska, Anna, Su, Mei-Hsin, Watson, Hunna J, Adams, Mark, Awasthi, Swapnil, Gandal, Michael, Hafferty, Jonathan D, Hishimoto, Akitoyo, Kim, Minsoo, Okazaki, Satoshi, Otsuka, Ikuo, Ripke, Stephan, Ware, Erin B, Bergen, Andrew W, Berrettini, Wade H, Bohus, Martin, Brandt, Harry, Chang, Xiao, Chen, Wei J, Chen, Hsi-Chung, Crawford, Steven, Crow, Scott, DiBlasi, Emily, Duriez, Philibert, Fernández-Aranda, Fernando, Fichter, Manfred M, Gallinger, Steven, Glatt, Stephen J, Gorwood, Philip, Guo, Yiran, Hakonarson, Hakon, Halmi, Katherine A, Hwu, Hai-Gwo, Jain, Sonia, Jamain, Stéphane, Jiménez-Murcia, Susana, Johnson, Craig, Kaplan, Allan S, Kaye, Walter H, Keel, Pamela K, Kennedy, James L, Klump, Kelly L, Li, Dong, Liao, Shih-Cheng, Lieb, Klaus, Lilenfeld, Lisa, Liu, Chih-Min, Magistretti, Pierre J, Marshall, Christian R, Mitchell, James E, Monson, Eric T, Myers, Richard M, Pinto, Dalila, Powers, Abigail, Ramoz, Nicolas, Roepke, Stefan, Rozanov, Vsevolod, Scherer, Stephen W, Schmahl, Christian, Sokolowski, Marcus, Strober, Michael, Thornton, Laura M, Treasure, Janet, Tsuang, Ming T, Witt, Stephanie H, Woodside, D Blake, Yilmaz, Zeynep, Zillich, Lea, Adolfsson, Rolf, Agartz, Ingrid, Air, Tracy M, Alda, Martin, Alfredsson, Lars, Andreassen, Ole A, Anjorin, Adebayo, Appadurai, Vivek, Soler Artigas, María, Van der Auwera, Sandra, Azevedo, M Helena, Bass, Nicholas, Bau, Claiton HD, Baune, Bernhard T, Bellivier, Frank, Berger, Klaus, Biernacka, Joanna M, Bigdeli, Tim B, Binder, Elisabeth B, Boehnke, Michael, Boks, Marco P, Bosch, Rosa, and Braff, David L
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Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium ,Bipolar Disorder Working Group of the Psychiatric Genomics Consortium ,Eating Disorders Working Group of the Psychiatric Genomics Consortium ,German Borderline Genomics Consortium ,MVP Suicide Exemplar Workgroup ,VA Million Veteran Program ,Humans ,Risk Factors ,Suicide ,Attempted ,Mental Disorders ,Depressive Disorder ,Major ,Polymorphism ,Single Nucleotide ,Genome-Wide Association Study ,Genetic correlation ,Genome-wide association study ,Pleiotropy ,Polygenicity ,Suicide ,Suicide attempt ,Human Genome ,Behavioral and Social Science ,Mental Health ,Prevention ,Genetics ,Brain Disorders ,Aetiology ,2.1 Biological and endogenous factors ,Mental health ,Good Health and Well Being ,Biological Sciences ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Psychiatry - Abstract
BackgroundSuicide is a leading cause of death worldwide, and nonfatal suicide attempts, which occur far more frequently, are a major source of disability and social and economic burden. Both have substantial genetic etiology, which is partially shared and partially distinct from that of related psychiatric disorders.MethodsWe conducted a genome-wide association study (GWAS) of 29,782 suicide attempt (SA) cases and 519,961 controls in the International Suicide Genetics Consortium (ISGC). The GWAS of SA was conditioned on psychiatric disorders using GWAS summary statistics via multitrait-based conditional and joint analysis, to remove genetic effects on SA mediated by psychiatric disorders. We investigated the shared and divergent genetic architectures of SA, psychiatric disorders, and other known risk factors.ResultsTwo loci reached genome-wide significance for SA: the major histocompatibility complex and an intergenic locus on chromosome 7, the latter of which remained associated with SA after conditioning on psychiatric disorders and replicated in an independent cohort from the Million Veteran Program. This locus has been implicated in risk-taking behavior, smoking, and insomnia. SA showed strong genetic correlation with psychiatric disorders, particularly major depression, and also with smoking, pain, risk-taking behavior, sleep disturbances, lower educational attainment, reproductive traits, lower socioeconomic status, and poorer general health. After conditioning on psychiatric disorders, the genetic correlations between SA and psychiatric disorders decreased, whereas those with nonpsychiatric traits remained largely unchanged.ConclusionsOur results identify a risk locus that contributes more strongly to SA than other phenotypes and suggest a shared underlying biology between SA and known risk factors that is not mediated by psychiatric disorders.
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- 2022
13. Satiety Does Not Alter the Ventral Striatum’s Response to Immediate Reward in Bulimia Nervosa
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Bischoff-Grethe, Amanda, Wierenga, Christina E, Bailer, Ursula F, McClure, Samuel M, and Kaye, Walter H
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Behavioral and Social Science ,Brain Disorders ,Basic Behavioral and Social Science ,Pediatric ,Nutrition ,Eating Disorders ,Clinical Research ,Neurosciences ,Mental health ,Bulimia Nervosa ,Female ,Humans ,Hunger ,Magnetic Resonance Imaging ,Reward ,Ventral Striatum ,bulimia nervosa ,fMRI ,impulsivity ,dorsal caudate ,ventral striatum - Abstract
Individuals with bulimia nervosa (BN) cycle between periods of binge-eating and compensatory behavior and periods of dietary restraint, suggesting extremes of under and overcontrol that may be metabolic-state related. This study examined the influence of hunger and satiety on impulsivity and neural responding during decision-making. Twenty-three women remitted from BN (RBN) and 20 healthy comparison women (CW) performed a delay discounting task after a 16-hr fast and following a standardized meal during functional neuroimaging. A dual-systems approach examined reward valuation (decision trials where the early reward option was available immediately) and cognitive control (all decision trials). Interactions of Group × Visit (Hungry, Fed) for immediate reward revealed that CW had greater activation when hungry versus fed in the ventral striatum and dorsal caudate, whereas RBN had greater response when fed versus hungry in the dorsal caudate. Compared to CW, RBN showed decreased response when hungry within the left dorsal caudate and ventral striatum and increased response when fed in bilateral dorsal caudate. No differences were found within cognitive control regions or with choice behavior. Reward sensitivity is normally increased when hungry and decreased when fed; our findings in CW provide further support of hunger-based reward sensitivity within the striatum. However, RBN showed no differences for hunger and satiety in the ventral striatum and greater activation in the dorsal caudate when fed compared to hungry. This suggests RBN may be less sensitive to reward when hungry but do not devalue reward when satiated, indicating altered metabolic modulation of self-regulatory control. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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- 2021
14. Associations of elevated weight status with symptom severity and treatment outcomes in binge/purge eating disorders
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Chen, Joanna Y, Berner, Laura A, Brown, Tiffany A, Wierenga, Christina E, and Kaye, Walter H
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Biomedical and Clinical Sciences ,Nutrition and Dietetics ,Mental Health ,Obesity ,Nutrition ,Clinical Research ,Eating Disorders ,Brain Disorders ,Behavioral and Social Science ,Adult ,Binge-Eating Disorder ,Bulimia Nervosa ,Female ,Humans ,Overweight ,Thinness ,Treatment Outcome ,binge eating ,bulimia nervosa ,eating disorders ,overweight ,purging ,treatment outcome ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Clinical Psychology ,Nutrition and dietetics ,Public health - Abstract
ObjectiveBinge-eating and purging behaviors commonly co-occur with overweight. However, little is known about the potential associations of elevated weight status with eating disorder severity or treatment outcomes. Thus, the present study compared binge-eating and purging patients with low, normal, and high weight statuses on eating disorder and mood symptoms at treatment admission, and tested whether weight status was associated with symptom change over treatment.MethodThe sample included 135 adult female patients in an intensive outpatient program, who completed self-assessments at admission and discharge. MANOVAs compared the groups at treatment admission, and multilevel models examined changes over time.ResultsAt admission, the high-weight group reported greater fasting frequency than the normal-weight group, and higher shape and weight concerns than the low-weight group. Over time, the high-weight group additionally showed higher eating disorder psychological symptom severity than the normal-weight group. The groups did not differ on mood symptoms at admission. Longitudinal results indicated that the groups showed comparable symptom improvements over treatment.DiscussionThese findings highlight the severity of higher-weight patients with bulimia nervosa. Additionally, although these patients may present with more severe symptoms, their response to an intensive treatment may be comparable to that of normal- or lower-weight groups.
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- 2021
15. Predictors of Stepping Up to Higher Level of Care Among Eating Disorder Patients in a Partial Hospitalization Program.
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Simpson, Courtney C, Towne, Terra L, Karam, Anna M, Donahue, Joseph M, Hadjeasgari, Carly F, Rockwell, Roxanne, and Kaye, Walter H
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eating disorder ,higher level of care ,inpatient ,partial hospitalization ,predictor ,residential ,Mental Health ,Health Services ,Nutrition ,Clinical Research ,Brain Disorders ,Depression ,Mental health ,Psychology ,Cognitive Sciences - Abstract
Partial hospitalization programming (PHP) is a treatment option available for individuals with eating disorders (ED) who have made insufficient progress in outpatient settings or are behaviorally or medically unstable. Research demonstrates that this level of care yields efficacy for the majority of patients. However, not all patients achieve recovery in PHP and later admit to a higher level of care (HLOC) including residential treatment or inpatient hospitalization. Although PHP is an increasingly common treatment choice for ED, research concerning outcome predictors in outpatient, stepped levels of care remains limited. Thus, the current study sought to identify the predictors of patients first admitted to PHP that later enter residential or inpatient treatment. Participants were 788 patients (after exclusions) enrolled in adolescent or adult partial hospitalization programs in a specialized ED clinic. When compared to patients who maintained treatment in PHP, a significantly greater proportion of patients who discharged to a HLOC had previously received ED residential treatment. Moreover, patients who discharged to a HLOC were diagnosed with a comorbid anxiety disorder and reported greater anxious and depressive symptomatology. A logistic regression model predicting discharge from PHP to a HLOC was significant, and lower body mass index (BMI) was a significant predictor of necessitating a HLOC. Supplemental programming in partial hospitalization settings might benefit individuals with previous ED residential treatment experience, higher levels of anxiety and depression, and lower BMIs. Specialized intervention for these cases is both practically and economically advantageous, as it might reduce the risk of rehospitalization and at-risk patients needing to step up to a HLOC.
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- 2021
16. Brain Neurotransmitters and Eating Disorders
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Murray, Susan, primary and Kaye, Walter H., additional
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- 2023
- Full Text
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17. Examining day hospital treatment outcomes for sexual minority patients with eating disorders
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Donahue, Joseph M, DeBenedetto, Anthony M, Wierenga, Christina E, Kaye, Walter H, and Brown, Tiffany A
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Biomedical and Clinical Sciences ,Clinical Sciences ,Clinical Research ,Brain Disorders ,Behavioral and Social Science ,Mental Health ,Eating Disorders ,Depression ,Mind and Body ,Sexual and Gender Minorities (SGM/LGBT*) ,Mental health ,Adult ,Feeding and Eating Disorders ,Female ,Hospitals ,Humans ,Male ,Sexual and Gender Minorities ,Surveys and Questionnaires ,Treatment Outcome ,Young Adult ,day hospital ,eating disorders ,minority stress ,sexual orientation ,treatment outcome ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Clinical Psychology ,Nutrition and dietetics ,Public health - Abstract
ObjectiveEpidemiological data support that sexual minorities (SM) report higher levels of eating pathology. Theories suggest these disparities exist due to stressors specific to belonging to a minority group; however, few studies have specifically explored differences between SM and heterosexual individuals in clinical eating disorder samples. Thus, the present study compared SM and heterosexual patients with eating disorders on demographic characteristics and eating disorder and psychological outcomes during day hospital treatment.MethodPatients (N = 389) completed surveys of eating pathology, mood, anxiety, and skills use at treatment admission, 1-month post-admission, discharge, and 6-month follow-up. Overall, 19.8% of patients (n = 79) identified as SM, while 8.0% (n = 32) reported not identifying with any sexual orientation. SM were more likely to present across genders (17.7% of females, 24.2% of males, 33.3% of transgender patients, and 87.5% of nonbinary patients).ResultsSM patients were significantly more likely to endorse major depressive disorder, panic disorder, and self-harm at admission than their heterosexual counterparts. Multilevel models demonstrated that across time, SM patients demonstrated greater eating pathology, emotion dysregulation, depressive symptoms, and anxiety symptoms. Significant interactions between sexual orientation and time were found for eating pathology and emotion dysregulation, such that although SM patients started treatment with higher scores, they improved at a faster rate compared to heterosexual patients.DiscussionConsistent with minority stress theory, SM patients report greater overall eating disorder and comorbid symptoms. Importantly, results do not support that there appear to be significant disparities in treatment outcome for SM patients in this sample of day hospital patients.
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- 2020
18. Early predictors of treatment outcome in a partial hospital program for adolescent anorexia nervosa
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Brown, Tiffany A, Murray, Stuart B, Anderson, Leslie K, and Kaye, Walter H
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Public Health ,Biomedical and Clinical Sciences ,Nutrition and Dietetics ,Health Sciences ,Clinical Research ,Anorexia ,Nutrition ,Mental Health ,Brain Disorders ,Eating Disorders ,Serious Mental Illness ,Pediatric ,Adolescent ,Adult ,Anorexia Nervosa ,Child ,Day Care ,Medical ,Female ,Humans ,Male ,Psychopathology ,Treatment Outcome ,Young Adult ,adolescent ,anorexia nervosa ,early change ,eating disorders ,partial hospital program ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Clinical Psychology ,Nutrition and dietetics ,Public health - Abstract
ObjectivePrevious research supports the relevance of early symptom change in eating disorder (ED) treatment; however, few studies have distinguished early weight change from early change in ED psychopathology, particularly in higher levels of care. Thus, the present study examined whether early change in weight and ED psychopathology predicted outcome for adolescents with anorexia nervosa (AN) in a partial hospitalization program.MethodAdolescents with AN (n = 99) completed assessments at admission, 1-month after treatment admission, discharge, and 6-month follow-up.ResultsHigher admission percent expected body weight (%EBW), greater early change in %EBW, longer duration of treatment, shorter length of illness, and earlier age of onset predicted greater change in %EBW at discharge, but not follow-up. Greater ED psychopathology at admission and greater early change in ED psychopathology predicted later change in ED symptoms at discharge, but not follow-up. Neither early change in %EBW nor ED psychopathology predicted likelihood of remission at discharge and follow-up.DiscussionResults support the importance of early change in predicting later change in the same ED outcome variables and suggest that early change in both %EBW and ED psychopathology in adolescents may be an important area for future research.
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- 2020
19. Increased anticipatory brain response to pleasant touch in women remitted from bulimia nervosa.
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Wierenga, Christina E, Bischoff-Grethe, Amanda, Berner, Laura A, Simmons, Alan N, Bailer, Ursula, Paulus, Martin P, and Kaye, Walter H
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Clinical Sciences ,Public Health and Health Services ,Psychology - Abstract
Bulimia nervosa (BN) is characterized by affective instability and dysregulated behaviors (binge eating, fasting, self-induced vomiting) that disrupt bodily homeostasis. Mechanisms underlying dysregulation in BN are unclear, although altered reward responsivity, anticipatory processing of environmental cues, and interoception (detection and integration of body-state signals to regulate behavior) have been implicated in BN pathophysiology. We aimed to determine whether BN is associated with ineffectively predicting body state or integrating predicted experience with actual experience by examining neural response to anticipation and experience of affective touch, a pleasant interoceptive stimulus that acts on sensory and emotional systems to guide behavior. During fMRI, we administered soft strokes to the palm and forearm in women remitted from BN (RBN; N = 23) and control women (CW; N = 25). A Group (RBN/CW) × Condition (anticipation/touch) interaction was found in the right dorsal caudate; both CW and RBN had increased activation during touch compared with anticipation, with RBN demonstrating marginally greater anticipatory response than CW. For RBN, those individuals who showed greater anticipatory response in the dorsal caudate also reported higher levels of harm avoidance. RBN individuals relative to CW showed greater activation in left putamen and insula during the anticipation but not when experiencing an affective touch. This increase during anticipation rather than the actual experience of the affective touch is consistent with a top-down preparatory process which is associated with harm avoidance and is similar to what has been observed in anxious individuals. This aberrant signal integration could disrupt feedback processing, serving to maintain disordered behavior.
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- 2020
20. Neural Insensitivity to the Effects of Hunger in Women Remitted From Anorexia Nervosa
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Kaye, Walter H, Wierenga, Christina E, Bischoff-Grethe, Amanda, Berner, Laura A, Ely, Alice V, Bailer, Ursula F, Paulus, Martin P, and Fudge, Julie L
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Clinical Trials and Supportive Activities ,Anorexia ,Eating Disorders ,Mental Health ,Serious Mental Illness ,Nutrition ,Brain Disorders ,Clinical Research ,Neurosciences ,Zero Hunger ,Adult ,Anorexia Nervosa ,Case-Control Studies ,Caudate Nucleus ,Cerebral Cortex ,Female ,Functional Neuroimaging ,Humans ,Hunger ,Magnetic Resonance Imaging ,Neural Pathways ,Putamen ,Remission Induction ,Taste ,Young Adult ,Feeding and Eating Disorders ,Neuroimaging ,Reward Processing ,fMRI ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Psychiatry - Abstract
OBJECTIVE:Anorexia nervosa has the highest mortality rate of any psychiatric condition, yet the pathophysiology of this disorder and its primary symptom, extreme dietary restriction, remains poorly understood. In states of hunger relative to satiety, the rewarding value of food stimuli normally increases to promote eating, yet individuals with anorexia nervosa avoid food despite emaciation. This study's aim was to examine potential neural insensitivity to these effects of hunger in anorexia nervosa. METHODS:At two scanning sessions scheduled 24 hours apart, one after a 16-hour fast and one after a standardized meal, 26 women who were in remission from anorexia nervosa (to avoid the confounding effects of malnutrition) and 22 matched control women received tastes of sucrose solution or ionic water while functional MRI data were acquired. Within a network of interest responsible for food valuation and transforming taste signals into motivation to eat, the authors compared groups across conditions on blood-oxygen-level-dependent (BOLD) signal and task-based functional connectivity. RESULTS:Participants in the two groups had similar BOLD responses to sucrose and water tastants. A group-by-condition interaction in the ventral caudal putamen indicated that hunger had opposite effects on tastant response in the control group and the remitted anorexia nervosa group, with an increase and a decrease, respectively, in BOLD response when hungry. Hunger had a similar opposite effect on insula-to-ventral caudal putamen functional connectivity in the remitted anorexia nervosa group compared with the control group. Exploratory analyses indicated that lower caudate response to tastants when hungry was associated with higher scores on harm avoidance among participants in the remitted anorexia nervosa group. CONCLUSIONS:Reduced recruitment of neural circuitry that translates taste stimulation to motivated eating behavior when hungry may facilitate food avoidance and prolonged periods of extremely restricted food intake in anorexia nervosa.
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- 2020
21. Body Mistrust Bridges Interoceptive Awareness and Eating Disorder Symptoms
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Brown, Tiffany A, Vanzhula, Irina A, Reilly, Erin E, Levinson, Cheri A, Berner, Laura A, Krueger, Angeline, Lavender, Jason M, Kaye, Walter H, and Wierenga, Christina E
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Biological Psychology ,Psychology ,Mental Health ,Nutrition ,Eating Disorders ,Adolescent ,Adult ,Age Factors ,Awareness ,Emotions ,Feeding and Eating Disorders ,Female ,Humans ,Interoception ,Male ,Young Adult ,network analysis ,interoceptive awareness ,eating disorder ,comorbidity ,Cognitive Sciences ,Clinical Psychology ,Applied and developmental psychology ,Clinical and health psychology ,Cognitive and computational psychology - Abstract
Interoceptive awareness (IA), or the awareness of internal body states, is known to be impaired in individuals with eating disorders (EDs); however, little is understood about how IA and ED symptoms are connected. Network analysis is a statistical approach useful for examining how symptoms interrelate and how comorbidities may be maintained. The present study used network analysis to (1) test central symptoms within an IA-ED network, (2) identify symptoms that may bridge the association between IA and ED symptoms, and (3) explore whether central and bridge symptoms predict ED remission at discharge from intensive treatment. A regularized partial correlation network was estimated in a sample of 428 adolescent (n = 187) and adult (n = 241) ED patients in a partial hospital program. IA was assessed using items from the Multidimensional Assessment of Interoceptive Awareness, and ED symptoms were assessed using items from the Eating Disorder Examination-Questionnaire. Central symptoms within the network were strong desire to lose weight, feeling guilty, and listening for information from the body about emotional state. The most central symptom bridging IA and ED symptoms was (not) feeling safe in one's body. Of the central symptoms, greater desire to lose weight predicted lower likelihood of remission at treatment discharge. Bridge symptoms did not significantly predict remission. Body mistrust may be a mechanism by which associations between IA and EDs are maintained. Findings suggest targeting central and bridge symptoms may be helpful to improve IA and ED symptoms. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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- 2020
22. Emotion Regulation Difficulties During and After Partial Hospitalization Treatment Across Eating Disorders
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Brown, Tiffany A, Cusack, Anne, Berner, Laura A, Anderson, Leslie K, Nakamura, Tiffany, Gomez, Lauren, Trim, Julie, Chen, Joanna Y, and Kaye, Walter H
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Brain Disorders ,Clinical Research ,Nutrition ,Eating Disorders ,Mental Health ,Serious Mental Illness ,Adolescent ,Adult ,Day Care ,Medical ,Emotional Regulation ,Emotions ,Feeding and Eating Disorders ,Female ,Humans ,Male ,Young Adult ,emotion regulation ,eating disorders ,treatment ,dialectical behavior therapy ,Psychology ,Clinical Psychology - Abstract
Emotion regulation deficits are associated with eating disorder (ED) symptoms, regardless of eating disorder diagnosis. Thus, recent treatment approaches for EDs, such as dialectical behavior therapy (DBT), have focused on teaching patients skills to better regulate emotions. The present study examined changes in emotion regulation among adult patients with EDs during DBT-oriented partial hospital treatment, and at follow-up (M[SD] = 309.58[144.59] days from discharge). Exploratory analyses examined associations between changes in emotion regulation and ED symptoms. Patients with anorexia nervosa, restricting (AN-R, n = 77), and binge-eating/purging subtype (AN-BP, n = 46), or bulimia nervosa (BN, n = 118) completed the Difficulties in Emotion Regulation Scale (DERS) at admission, discharge, and follow-up. Patients with BN demonstrated significant improvements across all facets of emotion dysregulation from admission to discharge and maintained improvements at follow-up. Although patients with AN-BP demonstrated statistically significant improvements on overall emotion regulation, impulsivity, and acceptance, awareness, and clarity of emotions, from admission to discharge, these improvements were not significant at follow-up. Patients with AN-R demonstrated statistically significant improvements on overall emotion dysregulation from treatment admission to discharge. Changes in emotion regulation were moderately correlated with changes in ED symptoms over time. Results support different trajectories of emotion regulation symptom change in DBT-oriented partial hospital treatment across ED diagnoses, with patients with BN demonstrating the most consistent significant improvements.
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- 2020
23. Correlates of co-occurring eating disorders and substance use disorders: a case for dialectical behavior therapy
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Claudat, Kimberly, Brown, Tiffany A, Anderson, Leslie, Bongiorno, Gina, Berner, Laura A, Reilly, Erin, Luo, Tana, Orloff, Natalia, and Kaye, Walter H
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Clinical and Health Psychology ,Social and Personality Psychology ,Psychology ,Drug Abuse (NIDA only) ,Eating Disorders ,Basic Behavioral and Social Science ,Substance Misuse ,Nutrition ,Clinical Research ,Mental Health ,Behavioral and Social Science ,Serious Mental Illness ,Brain Disorders ,Mental health ,Good Health and Well Being ,Adult ,Comorbidity ,Dialectical Behavior Therapy ,Emotions ,Feeding and Eating Disorders ,Female ,Humans ,Impulsive Behavior ,Longitudinal Studies ,Male ,Self-Injurious Behavior ,Substance-Related Disorders ,Medical and Health Sciences ,Studies in Human Society ,Psychology and Cognitive Sciences ,Clinical Psychology ,Health sciences ,Human society - Abstract
Given the high rates of comorbidity between eating disorders (EDs) and substance use disorders (SUDs), it is important to develop effective treatment approaches for individuals with both an ED and SUD (ED-SUD). To date, there is limited information guiding the concurrent treatment of these disorders. To build on existing research, the present study compared adult patients with ED-SUD (n = 36) to patients with ED-only (n = 62) in terms of demographics, psychiatric comorbidity, and self-reported eating disorder and related psychopathology. Results indicated that ED-SUD patients had a higher number of psychiatric comorbidities, were more likely to be prescribed mood stabilizers, and were more sensitive to reward. They also reported greater difficulty with emotion regulation, including more difficulty engaging in goal-directed activity, higher impulsivity, and more limited access to emotion regulation strategies. These differences highlight the importance of targeting emotion dysregulation for ED-SUD, and provide evidence for the importance of integrated, transdiagnostic treatment to simultaneously address the SUD, ED, and other psychiatric comorbidities. Implications for tailoring treatment are discussed with a focus on Dialectical Behavior Therapy (DBT).
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- 2020
24. Dialectical behavioral therapy for the treatment of adolescent eating disorders: a review of existing work and proposed future directions
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Reilly, Erin E, Orloff, Natalia C, Luo, Tana, Berner, Laura A, Brown, Tiffany A, Claudat, Kimberly, Kaye, Walter H, and Anderson, Leslie K
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Clinical and Health Psychology ,Psychology ,Eating Disorders ,Nutrition ,Pediatric ,Mental Health ,Behavioral and Social Science ,Mind and Body ,Adolescent ,Behavior Therapy ,Emotions ,Feeding and Eating Disorders ,Humans ,Medical and Health Sciences ,Studies in Human Society ,Psychology and Cognitive Sciences ,Clinical Psychology ,Health sciences ,Human society - Abstract
Over the past several decades, Dialectical Behavior Therapy (DBT) has been adapted for a range of presenting problems related to emotion dysregulation. Considerable enthusiasm exists regarding the use of DBT for treating eating disorders; however, to date, there have been no reviews summarizing empirical efforts to adapt DBT for eating disorders in youth. Accordingly, in the present narrative review, we provide a comprehensive summary of existing work testing DBT for adolescent eating disorders. First, we briefly review existing work applying DBT to eating disorders in adults and general adolescent samples. We then review research focused specifically on the use of DBT for adolescent eating disorders, including both those studies applying DBT as the primary treatment and investigations of DBT as an adjunctive treatment. Overall, initial results for DBT-based approaches are promising. However, rigorous empirical work testing DBT for treating adolescent eating disorders remains limited; the majority of existing research is comprised of case series and small-scale studies. Therefore, we close with specific recommendations for future research testing this approach.
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- 2020
25. Therapist adherence to family‐based treatment for adolescents with anorexia nervosa: A multi‐site exploratory study
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Dimitropoulos, Gina, Lock, James D, Agras, William Stewart, Brandt, Harry, Halmi, Katherine A, Jo, Booil, Kaye, Walter H, Pinhas, Leora, Wilfley, Denise E, and Woodside, D Blake
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Clinical and Health Psychology ,Biomedical and Clinical Sciences ,Psychology ,Pediatric ,Mental Health ,Eating Disorders ,Anorexia ,Nutrition ,7.1 Individual care needs ,Management of diseases and conditions ,Adolescent ,Anorexia Nervosa ,Family Therapy ,Humans ,Patient Compliance ,Treatment Outcome ,adolescents ,anorexia nervosa ,family-based treatment ,fidelity ,Clinical Sciences ,Clinical Psychology ,Clinical sciences ,Nutrition and dietetics ,Clinical and health psychology - Abstract
ObjectiveThis exploratory study is the first to examine family-based treatment (FBT) adherence and association to treatment outcome in the context of a large-scale, multi-centre study for the treatment of adolescents with anorexia nervosa.MethodOne hundred and ninety recorded FBT sessions from 68 adolescents with anorexia nervosa and their families were recruited across multiple sites (N = 6). Each site provided 1-4 tapes per family over four treatment time points, and each was independently rated for therapist adherence.ResultsThere were differences in adherence scores within and between sites. ANOVA produced a main effect for site, F(5, 46) = 8.6, p
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- 2020
26. Anhedonia in Eating Disorders
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Murray, Susan M., Brown, Carina S., Kaye, Walter H., Wierenga, Christina E., Geyer, Mark A., Series Editor, Marsden, Charles A., Series Editor, Ellenbroek, Bart A., Series Editor, Barnes, Thomas R.E., Series Editor, Andersen, Susan L., Series Editor, Paulus, Martin P., Series Editor, and Pizzagalli, Diego A., editor
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- 2022
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27. Neuroendocrinology of reward in anorexia nervosa and bulimia nervosa: Beyond leptin and ghrelin
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Berner, Laura A, Brown, Tiffany A, Lavender, Jason M, Lopez, Emily, Wierenga, Christina E, and Kaye, Walter H
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Pharmacology and Pharmaceutical Sciences ,Biomedical and Clinical Sciences ,Mental Health ,Nutrition ,Brain Disorders ,Serious Mental Illness ,Neurosciences ,Eating Disorders ,Anorexia ,2.3 Psychological ,social and economic factors ,Aetiology ,Mental health ,Animals ,Anorexia Nervosa ,Bulimia Nervosa ,Ghrelin ,Humans ,Leptin ,Neuroendocrinology ,Reward ,Anorexia nervosa ,Bulimia nervosa ,Dopamine ,Biological Sciences ,Agricultural and Veterinary Sciences ,Medical and Health Sciences ,Endocrinology & Metabolism ,Biochemistry and cell biology ,Genetics ,Clinical sciences - Abstract
The pathophysiology of anorexia nervosa (AN) and bulimia nervosa (BN) are still poorly understood, but psychobiological models have proposed a key role for disturbances in the neuroendocrines that signal hunger and satiety and maintain energy homeostasis. Mounting evidence suggests that many neuroendocrines involved in the regulation of homeostasis and body weight also play integral roles in food reward valuation and learning via their interactions with the mesolimbic dopamine system. Neuroimaging data have associated altered brain reward responses in this system with the dietary restriction and binge eating and purging characteristic of AN and BN. Thus, neuroendocrine dysfunction may contribute to or perpetuate eating disorder symptoms via effects on reward circuitry. This narrative review focuses on reward-related neuroendocrines that are altered in eating disorder populations, including peptide YY, insulin, stress and gonadal hormones, and orexins. We provide an overview of the animal and human literature implicating these neuroendocrines in dopaminergic reward processes and discuss their potential relevance to eating disorder symptomatology and treatment.
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- 2019
28. Task‐switching inefficiencies in currently ill, but not remitted anorexia nervosa
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Berner, Laura A, Romero, Emily M, Reilly, Erin E, Lavender, Jason M, Kaye, Walter H, and Wierenga, Christina E
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Public Health ,Biomedical and Clinical Sciences ,Nutrition and Dietetics ,Health Sciences ,Behavioral and Social Science ,Mental Health ,Eating Disorders ,Anorexia ,Clinical Research ,Clinical Trials and Supportive Activities ,Mental health ,Adult ,Anorexia Nervosa ,Executive Function ,Female ,Humans ,Male ,Neuropsychological Tests ,Young Adult ,anorexia nervosa ,cognitive flexibility ,executive function ,task switching ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Clinical Psychology ,Nutrition and dietetics ,Public health - Abstract
ObjectiveModels of anorexia nervosa (AN) posit that set-shifting deficits may contribute to behavioral inflexibility and extreme dietary restriction. Findings from neurocognitive studies of set-shifting in AN have been somewhat mixed, perhaps due to the use of tasks that cannot distinguish shifting from other processes (i.e., learning). To more precisely characterize cognitive flexibility and selectively assess this process independent of rule learning and feedback sensitivity, we examined task-switching ability in AN.MethodWomen ill with AN, subthreshold AN or atypical AN (IAN; n = 40), women remitted from AN (RAN; n = 24), and age-matched healthy control women (n = 42) completed a computerized cued color-shape task-switching paradigm. Groups were compared on mix costs (reflecting global cognitive control) and switch costs (reflecting transient cognitive control).ResultsAlthough mix costs were equivalent across groups, switch costs were more pronounced in the IAN group, as indicated by a group-by-trial type interaction for reaction times on stay and switch trials.DiscussionFindings indicate that IAN, but not RAN, have difficulty flexibly switching between cognitive task sets, and suggest that prior findings of set-shifting deficits in AN may reflect difficulty with cognitive flexibility independent of learning deficits. As such, task-switching may represent a promising adjunctive treatment target.
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- 2019
29. Development and validation of the Premorbid Childhood Traits Questionnaire (PCT-Q) in eating disorders
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Marzola, Enrica, Fassino, Secondo, Migliaretti, Giuseppe, Abbate-Daga, Giovanni, and Kaye, Walter H
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Social and Personality Psychology ,Biomedical and Clinical Sciences ,Psychology ,Clinical Research ,Adolescent ,Adult ,Affective Symptoms ,Case-Control Studies ,Child ,Feeding and Eating Disorders ,Female ,Humans ,Male ,Phobia ,Social ,Prodromal Symptoms ,Reproducibility of Results ,Retrospective Studies ,Surveys and Questionnaires ,Young Adult ,Anorexia nervosa ,Premorbid trait ,Childhood ,Harm avoidance ,Interoceptive awareness ,Clinical Sciences ,Clinical Psychology ,Clinical sciences ,Nutrition and dietetics ,Clinical and health psychology - Abstract
PurposeSome features of eating disorders (EDs) are often present in childhood before the onset of the ED. We developed a novel questionnaire to retrospectively capture such childhood traits.MethodsFocus groups were conducted at the University of California-San Diego, USA, and at the University of Turin, Italy. Three focus groups were conducted at each site, interviewing patients and parents to identify those traits that most commonly characterize childhood of patients with EDs. A preliminary version of the Premorbid Childhood Traits Questionnaire (PCT-Q) derived from these focus groups was then administered to 94 consecutive inpatients with an ED and to 286 healthy controls (HCs) at the Turin site. Also, 208 participants' parents were enrolled as well; in fact, the PCT-Q was developed with both a proband and an informant version.ResultsA 37-item final version of the PCT-Q was generated. Reliability analyses suggested acceptability for harm avoidance (HA), social phobia, alexithymia, interoceptive awareness (IA), and food obsessions. Inter-rater reliability ranged from fair to moderate. ED sufferers scored significantly higher than HCs on HA, social phobia, alexithymia, IA, and food obsessions.ConclusionsThese findings support the possibility that premorbid traits contribute to a risk to develop an ED in some individuals.Level of evidenceIII: case-control analytic study.
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- 2019
30. Pilot study of a water load test as a measure of gastric interoception in anorexia nervosa
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Brown, Tiffany A., Perry, Taylor R., Kaye, Walter H., and Wierenga, Christina E.
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- 2022
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31. Comparing changes in eating disorder psychopathology and comorbid symptoms over treatment in anorexia nervosa and atypical anorexia nervosa in a partial hospitalization program
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Perry, Taylor R., primary, Lusich, Rylee, additional, Billman Miller, Marley G., additional, Kaye, Walter H., additional, Wierenga, Christina E., additional, and Brown, Tiffany A., additional
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- 2024
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32. Weight gained during treatment predicts 6‐month body mass index in a large sample of patients with anorexia nervosa using ensemble machine learning
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Frank, Guido K. W., primary, Stoddard, Joel J., additional, Brown, Tiffany, additional, Gowin, Josh, additional, and Kaye, Walter H., additional
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- 2024
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33. Brain Structure in Acutely Underweight and Partially Weight-Restored Individuals With Anorexia Nervosa: A Coordinated Analysis by the ENIGMA Eating Disorders Working Group
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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
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- 2022
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34. Common Genetic Variation and Age of Onset of Anorexia Nervosa
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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.
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- 2022
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35. A process approach to verbal memory assessment: Exploratory evidence of inefficient learning in women remitted from anorexia nervosa
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Stedal, Kristin, Ely, Alice V, Kurniadi, Natalie, Lopez, Emily, Kaye, Walter H, and Wierenga, Christina E
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Clinical and Health Psychology ,Psychology ,Mental Health ,Behavioral and Social Science ,Basic Behavioral and Social Science ,Eating Disorders ,Clinical Research ,Anorexia ,Mental health ,Adult ,Anorexia Nervosa ,Executive Function ,Female ,Humans ,Learning ,Learning Disabilities ,Memory Disorders ,Middle Aged ,Neuropsychological Tests ,Psychomotor Performance ,Remission Induction ,Young Adult ,Anorexia nervosa ,California verbal learning test ,neuropsychology ,verbal learning ,error analysis ,Neurosciences ,Cognitive Sciences ,Experimental Psychology ,Biological psychology ,Clinical and health psychology ,Cognitive and computational psychology - Abstract
Introduction: Anorexia nervosa (AN) is associated with deficits in set-shifting and cognitive flexibility, yet less is known about the persistence of these deficits after recovery and how they might contribute to reported difficulties organizing and learning new information. To address this question, the current study applied a process-focused approach, that accounts for errors and strategies by which a score is achieved, to investigate the relationship between verbal memory and executive function in women remitted from AN. Method: Twenty-six women remitted from anorexia nervosa (RAN) and 25 control women (CW) aged 19-45 completed the California Verbal Learning Test, Second edition (CVLT-II) and the Wisconsin Card Sorting Test (WCST). Groups were compared on overall achievement scores, and on repetition, intrusion, and perseverative errors on both tests. Associations between learning and memory performance and WCST errors were also examined. Results: RAN and CW groups did not differ on overall CVLT-II learning and memory performance or errors on the WCST, though the RAN group trended towards greater WCST non-perseverative and total errors. On the CVLT-II, the RAN group made significantly more repetition errors than CW (p = 0.010), and within-trial perseveration (WTP) errors (p = 0.044). For the CW group, CVLT-II learning and memory performance were negatively associated with errors on the WCST, whereas among RAN, primarily delayed memory was negatively correlated with WCST errors. Notably, for RAN, greater WCST perseverative responses were correlated with greater CVLT-II repetition and WTP errors, showing the convergence of perseverative responding across tasks. Conclusions: Despite similar overall learning and memory performance, difficulties with executive control seem to persist even after symptom remission in patients with AN. Results indicate an inefficient learning process in the cognitive phenotype of AN and support the use of process approaches to refine neuropsychological assessment of AN by accounting for strategy use.
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- 2019
36. Exploring the cooccurrence of behavioural phenotypes for avoidant/restrictive food intake disorder in a partial hospitalization sample
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Reilly, Erin E, Brown, Tiffany A, Gray, Emily K, Kaye, Walter H, and Menzel, Jessie E
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Biological Psychology ,Biomedical and Clinical Sciences ,Psychology ,Clinical Research ,Mental health ,Adolescent ,Avoidant Restrictive Food Intake Disorder ,Child ,Day Care ,Medical ,Eating ,Fear ,Feeding Behavior ,Female ,Humans ,Male ,Phenotype ,Retrospective Studies ,appetite ,avoidant ,restrictive food intake disorder ,eating disorder ,negative affect ,selective eating ,avoidant/restrictive food intake disorder ,Clinical Sciences ,Clinical Psychology ,Clinical sciences ,Nutrition and dietetics ,Clinical and health psychology - Abstract
ObjectiveLiterature providing clinical characterizations of avoidant/restrictive food intake disorder (ARFID) has proposed the occurrence of three functions for food refusal: fear of negative consequences, lack of hunger, or sensory sensitivity. Recent studies have suggested that these functions may be used to subtype patients presenting with ARFID; however, other work suggests that these categories are not mutually exclusive and instead represent neurobiological dimensions that can cooccur. The current study explored the potential cooccurrence of behavioural phenotypes in patients with ARFID presenting to a partial hospitalization program.MethodTwo raters conducted a retrospective chart review of patients with ARFID presenting to treatment from June 2014 to May 2018 (N = 59).ResultsRegarding cooccurrence of symptoms consistent with behavioural phenotypes, raters showed excellent agreement, and over 50% of the sample endorsed symptoms consistent with more than one phenotype. The sensory sensitivity phenotype was most common in the sample and frequently cooccurred with both other phenotypes.DiscussionResults suggest that multiple functions for food avoidance may be present within one individual. Future work should aim to further characterize individuals presenting with singular versus multiple phenotype characteristics.
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- 2019
37. Altered anticipation and processing of aversive interoceptive experience among women remitted from bulimia nervosa
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Berner, Laura A, Simmons, Alan N, Wierenga, Christina E, Bischoff-Grethe, Amanda, Paulus, Martin P, Bailer, Ursula F, and Kaye, Walter H
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Mental Health ,Nutrition ,Neurosciences ,Brain Disorders ,Eating Disorders ,Behavioral and Social Science ,Underpinning research ,1.1 Normal biological development and functioning ,Adult ,Anticipation ,Psychological ,Brain ,Brain Mapping ,Bulimia Nervosa ,Female ,Humans ,Inhalation ,Interoception ,Magnetic Resonance Imaging ,Stress ,Psychological ,Young Adult ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Psychiatry - Abstract
Bulimia nervosa (BN) is characterized by dysregulated intake of food, which may indicate homeostatic imbalance. Critically important for homeostatic regulation is interoception, or the sensing and processing of body-relevant information. A well-documented link between avoidance of unpleasant body sensations and BN symptoms suggests that aversive interoceptive experiences may be particularly relevant to BN pathophysiology. This study examined whether individuals with a history of BN show aberrant neural processing of aversive interoceptive stimuli. Using a cued inspiratory breathing load paradigm, we compared women remitted from BN (RBN; n = 24; to reduce the confounding effects of active bulimic symptoms) and control women (CW; n = 25). During breathing load anticipation, the RBN group, relative to CW, showed increased activation in mid-insula, superior frontal gyrus, putamen, dorsal anterior cingulate, posterior cingulate, and amygdala. However, over the course of the aversive experience, neural activation in RBN relative to CW showed an aberrant decline in most of these regions. Exploratory analyses indicated that greater activation during breathing load anticipation was associated with past bulimic symptom severity and the duration of symptom remission. An exaggerated anticipatory response and an abnormally decreasing response during aversive homeostatic perturbations may promote hallmark bulimic behaviors-binge eating, dietary restriction, and purging. Our findings support a role for homeostatic instability in BN, and these altered patterns of brain activation may serve as novel targets for pharmacological, neuromodulatory, and behavioral interventions.
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- 2019
38. Associations between dimensions of anorexia nervosa and obsessive–compulsive disorder: An examination of personality and psychological factors in patients with anorexia nervosa
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Levinson, Cheri A, Zerwas, Stephanie C, Brosof, Leigh C, Thornton, Laura M, Strober, Michael, Pivarunas, Bernadette, Crowley, James J, Yilmaz, Zeynep, 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, Woodside, D Blake, Kaye, Walter H, and Bulik, Cynthia M
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Clinical and Health Psychology ,Social and Personality Psychology ,Psychology ,Serious Mental Illness ,Clinical Research ,Eating Disorders ,Mental Health ,Nutrition ,Brain Disorders ,Anorexia ,Mental health ,Adolescent ,Adult ,Anorexia Nervosa ,Comorbidity ,Female ,Humans ,Obsessive-Compulsive Disorder ,Personality ,Young Adult ,anorexia nervosa ,comorbidity ,concern over mistakes ,obsessive-compulsive disorder ,transdiagnostic ,Clinical Sciences ,Clinical Psychology ,Clinical sciences ,Nutrition and dietetics ,Clinical and health psychology - Abstract
OBJECTIVE:Anorexia nervosa (AN) and obsessive-compulsive disorder (OCD) are highly comorbid. However, the factors that account for this comorbidity are poorly understood. We examined the core dimensions of AN and OCD and psychological and personality factors shared by both disorders. METHOD:In path analyses (N = 732 women with either current AN or recovered from AN), we examined which factors were uniquely and independently associated with the core dimensions of AN and OCD. We also examined recovery from AN as a moderator. RESULTS:When individuals with AN reported greater concern over mistakes, they endorsed more severity in both AN and OCD core dimensions. These unique associations existed above and beyond all other transdiagnostic personality and psychological factors and regardless of AN recovery status. CONCLUSIONS:Concern over mistakes partially accounts for severity in the core dimensions of both AN and OCD. Concern over mistakes may represent an important target in the aetiology of AN and OCD.
- Published
- 2019
39. Differences in emotion regulation difficulties among adults and adolescents across eating disorder diagnoses
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Anderson, Leslie K, Claudat, Kimberly, Cusack, Anne, Brown, Tiffany A, Trim, Julie, Rockwell, Roxanne, Nakamura, Tiffany, Gomez, Lauren, and Kaye, Walter H
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Clinical and Health Psychology ,Psychology ,Clinical Research ,Nutrition ,Pediatric ,Mental Health ,Serious Mental Illness ,Eating Disorders ,Brain Disorders ,Anorexia ,Mental health ,Adolescent ,Adult ,Affective Symptoms ,Anorexia Nervosa ,Bulimia Nervosa ,Child ,Female ,Humans ,Middle Aged ,Self-Control ,Young Adult ,anorexia nervosa ,bulimia nervosa ,DERS ,eating disorders ,emotion regulation ,Cognitive Sciences ,Clinical Psychology ,Clinical sciences ,Applied and developmental psychology ,Clinical and health psychology - Abstract
OBJECTIVE:Although much empirical attention has been devoted to emotion regulation (ER) in individuals with eating disorders, little is known about ER across a wide age range and among different ED subtypes. The current study sought to examine ER in a sample of eating disorder patients. METHOD:A total of 364 adults and adolescents with anorexia nervosa restricting subtype (AN-R), anorexia nervosa binge/purge subtype (AN-BP), or bulimia nervosa (BN) were assessed with the Difficulties in Emotion Regulation Scale (DERS). RESULTS:Older ages were associated with higher DERS total, nonacceptance, goals, and impulsivity scores. When controlling for age, patients with BN and AN-BP had higher overall DERS scores than those with AN, and there were some differences among diagnostic subtypes on specific facets of ER. CONCLUSIONS:These results indicate that treatments for emotion dysregulation may be applied across eating disorder diagnoses and ages, and inform how these strategies apply to different diagnostic groups.
- Published
- 2018
40. Exploring skill utilization as a mechanism of dialectical behavioral therapy among adults with eating disorders in a partial hospitalization program
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Karam, Anna M., Bohrer, Brittany K., Wierenga, Christina E., Anderson, Leslie K., Kaye, Walter H., and Brown, Tiffany A.
- Published
- 2022
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41. Early change in gastric‐specific anxiety sensitivity as a predictor of eating disorder treatment outcome.
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Velkoff, Elizabeth A., Lusich, Rylee, Kaye, Walter H., Wierenga, Christina E., and Brown, Tiffany A.
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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]
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- 2024
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42. Psilocybin Therapy for Females With Anorexia Nervosa: A Phase 1, Open-Label Feasibility Study.
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Peck, Stephanie Knatz, Shao, Samantha, Gruen, Tessa, Yang, Kevin, Babakanian, Alexandra, Trim, Julie, Finn, Daphna M., and Kaye, Walter H.
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- 2024
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43. Neural hypersensitivity to pleasant touch in women remitted from anorexia nervosa.
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Bischoff-Grethe, Amanda, Wierenga, Christina E, Berner, Laura A, Simmons, Alan N, Bailer, Ursula, Paulus, Martin P, and Kaye, Walter H
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Brain ,Neural Pathways ,Humans ,Magnetic Resonance Imaging ,Brain Mapping ,Case-Control Studies ,Touch ,Anorexia Nervosa ,Adult ,Female ,Functional Neuroimaging ,Interoception ,Clinical Sciences ,Public Health and Health Services ,Psychology - Abstract
Interoception, or the sensing and integration of bodily state signals, has been implicated in anorexia nervosa (AN), given that the hallmark symptoms involve food restriction and body image disturbance. Here we focus on brain response to the anticipation and experience of affective interoceptive stimuli. Women remitted from AN (RAN; N = 18) and healthy comparison women (CW; N = 26) underwent a pleasant affective touch paradigm consisting of gentle strokes with a soft brush administered to the forearm or palm during functional neuroimaging. RAN had a lower brain response relative to CW during anticipation of touch, but a greater response when experiencing touch in the right ventral mid-insula. In RAN, this reduced anticipatory response was associated with higher levels of harm avoidance. Exploratory analyses in RAN also suggested that lower response during touch anticipation was associated with greater body dissatisfaction and higher perceived touch intensity ratings. This reduced responsivity to the anticipation of pleasant affective interoceptive stimuli in association with higher harm avoidance, along with an elevated response to the experience of touch, suggests an impaired ability in AN to predict and interpret incoming physiological stimuli. Impaired interoception may thus impact one's sense of self, thereby supporting observations of disturbed body image and avoidance of affective and social stimuli. Therapeutic approaches that help AN to better anticipate and interpret salient affective stimuli or improve tolerance of interoceptive experiences may be an important addition to current interventions.
- Published
- 2018
44. Mirtazapine and Weight Gain in Avoidant and Restrictive Food Intake Disorder
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Gray, Emily, Chen, Theresa, Menzel, Jessie, Schwartz, Terry, and Kaye, Walter H
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Biomedical and Clinical Sciences ,Biological Psychology ,Nutrition and Dietetics ,Psychology ,Pharmacology and Pharmaceutical Sciences ,Clinical Research ,Prevention ,Digestive Diseases ,Mental Health ,Brain Disorders ,Nutrition ,6.1 Pharmaceuticals ,Evaluation of treatments and therapeutic interventions ,Mental health ,Zero Hunger ,Adolescent ,Adult ,Antidepressive Agents ,Anxiety Disorders ,Child ,Feeding and Eating Disorders ,Female ,Humans ,Male ,Mirtazapine ,Mood Disorders ,Off-Label Use ,Retrospective Studies ,Weight Gain ,Young Adult ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Developmental & Child Psychology ,Clinical sciences ,Paediatrics ,Applied and developmental psychology - Abstract
Avoidant and restrictive food intake disorder (ARFID) is a newly classified disorder in the DSM-5 that describes a pattern of restrictive eating across the lifespan that results in significant weight loss, nutritional deficiency, dependence on enteral feeding or nutritional supplements, or marked interference in psychosocial functioning.1 Currently, there are no evidence-based treatment approaches or medications for this disorder.2 We have administered a range of psychoactive medications to those with ARFID in our treatment program in an attempt to find an effective medication. One medication of interest has been mirtazapine because it promotes appetite and weight gain, decreases nausea and vomiting, and improves gastric emptying. Although mirtazapine is an off-label approach in a pediatric population and carries a black box warning for an increased risk of suicide, it is an effective treatment for depression and anxiety symptoms in adults and is generally well tolerated.3,4 There are no studies to date reporting on the use of mirtazapine in patients with ARFID.
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- 2018
45. The Impact of Alexithymia on Emotion Dysregulation in Anorexia Nervosa and Bulimia Nervosa over Time
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Brown, Tiffany A, Avery, Jade C, Jones, Michelle D, Anderson, Leslie K, Wierenga, Christina E, and Kaye, Walter H
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Clinical and Health Psychology ,Psychology ,Nutrition ,Eating Disorders ,Brain Disorders ,Anorexia ,Mental Health ,Serious Mental Illness ,Clinical Research ,Adult ,Affective Symptoms ,Anorexia Nervosa ,Bulimia Nervosa ,Emotions ,Female ,Hospitalization ,Humans ,Patient Discharge ,Self-Control ,alexithymia ,emotion regulation ,eating disorders ,anorexia nervosa ,bulimia nervosa ,Clinical Sciences ,Clinical Psychology ,Clinical sciences ,Nutrition and dietetics ,Clinical and health psychology - Abstract
Research supports that anorexia nervosa-restricting subtype (AN-R) and bulimia nervosa (BN) are associated with emotion regulation difficulties and alexithymia. However, the impact of diagnosis on the relationship between these constructs is less well understood. The purpose of the present study was to examine whether eating disorder diagnosis moderated the association between admission alexithymia and emotion regulation through discharge. Adult patients with AN-R (n = 54) and BN (n = 60) completed assessments at treatment admission and discharge from a partial hospital program. Eating disorder diagnosis moderated the association between admission alexithymia levels and change in global emotion dysregulation, impulse control difficulties and access to emotion regulation strategies. At higher levels of admission alexithymia, there were no differences between AN-R and BN on emotion dysregulation, whereas at lower levels of alexithymia, AN-R patients demonstrated lower levels of emotion dysregulation. Results imply that difficulties with alexithymia appear to have a greater impact on emotion dysregulation for AN-R patients. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
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- 2018
46. We are only at the tip of the iceberg: A commentary on higher levels of care for anorexia nervosa
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Chen, Eunice Y and Kaye, Walter H
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Psychology ,Clinical and Health Psychology ,Applied and Developmental Psychology ,anorexia nervosa ,dissemination ,inpatient treatment ,residential treatment ,Cognitive Sciences ,Clinical Psychology ,Applied and developmental psychology ,Clinical and health psychology - Published
- 2018
47. A pilot open series of lamotrigine in DBT-treated eating disorders characterized by significant affective dysregulation and poor impulse control
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Trunko, Mary Ellen, Schwartz, Terry A, Berner, Laura A, Cusack, Anne, Nakamura, Tiffany, Bailer, Ursula F, Chen, Joanna Y, and Kaye, Walter H
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Biological Psychology ,Clinical and Health Psychology ,Psychology ,Mental Health ,Serious Mental Illness ,Clinical Research ,Clinical Trials and Supportive Activities ,Nutrition ,Behavioral and Social Science ,Eating Disorders ,Brain Disorders ,Anorexia ,Anticonvulsants ,Binge eating ,Purging ,Emotion dysregulation ,Lamotrigine ,Cognitive Sciences ,Applied and developmental psychology ,Biological psychology ,Clinical and health psychology - Abstract
BackgroundThere is little effective psychopharmacological treatment for individuals with eating disorders who struggle with pervasive, severe affective and behavioral dysregulation.MethodsThis pilot open series evaluated lamotrigine, a mood stabilizer, in the treatment of patients with eating disorders who did not respond adequately to antidepressant medications. Nine women with anorexia nervosa- or bulimia nervosa-spectrum eating disorders in partial hospital or intensive outpatient dialectical behavior therapy (DBT)-based eating disorder treatment took lamotrigine for 147 ± 79 days (mean final dose = 161.1 ± 48.6 mg/day). Participants completed standardized self-report measures of emotion dysregulation and impulsivity after lamotrigine initiation and approximately biweekly thereafter. Mood and eating disorder symptomatology were measured at lamotrigine initiation and at time of final assessment.ResultsLamotrigine and concurrent DBT were associated with large reductions in self-reported affective and behavioral dysregulation (ps
- Published
- 2017
48. Effects of borderline personality disorder symptoms on dialectical behavior therapy outcomes for eating disorders.
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Denning, Dominic M., primary, Ciotti, Victoria, additional, Gioia, Ayla, additional, Viranda, Thalia, additional, Reilly, Erin E., additional, Berner, Laura A., additional, Velkoff, Elizabeth A., additional, Anderson, Leslie K., additional, Kaye, Walter H., additional, Wierenga, Christina E., additional, and Brown, Tiffany A., additional
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- 2024
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49. Interoceptive Awareness and Suicidal Ideation in a Clinical Eating Disorder Sample: The Role of Body Trust
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Perry, Taylor R., Wierenga, Christina E., Kaye, Walter H., and Brown, Tiffany A.
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- 2021
- Full Text
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50. Intolerance of Uncertainty and Eating Disorder Symptoms Over the Course of Intensive Treatment
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Reilly, Erin E., Perry, Taylor R., Brown, Tiffany A., Wierenga, Christina E., and Kaye, Walter H.
- Published
- 2021
- Full Text
- View/download PDF
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