Utzinger, Linsey M; Mitchell, James E; Cao, Li; Crosby, Ross D; Crow, Scott J; Wonderlich, Stephen A; Peterson, Carol B
2015-09-01
This study examined whether having a history of anorexia nervosa (AN) or bulimia nervosa (BN) is associated with response to treatment in adults with binge eating disorder (BED). Data from 189 adults diagnosed with BED who were randomly assigned to one of three group cognitive-behavioral (CBT) treatments were analyzed to compare those with and without a history of AN/BN. A total of 16% of the sample had a history of AN/BN. The BED subgroup with a history of AN/BN presented with higher rates of mood disorders and greater eating-related symptom severity at baseline. Participants with a history of AN/BN also had higher global eating disorder (ED) symptoms at end of treatment (EOT), and more frequent objective binge-eating episodes at EOT and 12-month follow-up. These findings suggest that in adults with BED, a history of AN/BN is predictive of greater eating-related symptom severity following group-based CBT and poorer short- and long-term binge-eating outcomes. These findings suggest that considering ED history in the treatment of adults with BED may be clinically useful. © 2015 Wiley Periodicals, Inc.
Interpreting genetics in the context of eating disorders: Evidence of disease, not diversity
Easter, Michele
2013-01-01
How is genetic involvement interpreted for disorders whose medicalisation is contested? Framing psychiatric and behavioral disorders in terms of genetics is expected to make them seem “more medical.” Yet, genetic etiology can also be used to frame behavior as acceptable human variation, rather than a medical problem (e.g., sexual orientation). I analyze responses to the idea of a genetic component in anorexia and bulimia nervosa (AN/BN) via semi-structured interviews with a sample of 50 women diagnosed with an eating disorder (25 recovered). All but three volunteered that genetics would medicalise AN/BN, by (1) making eating disorders seem more like “real” diseases; (2) implying a need for professional treatment; or (3) for biologically-based treatment. Results also indicate several “counter-logics,” by which genetic framing could support non-medical definitions of AN/BN. I argue that genetic framing reduces perceived individual responsibility, which can support definitions of behavior as either a reflection of disease (which entails intervention) or a reflection of normal human diversity (which does not). In the context of public skepticism as to the “reality” of AN/BN, genetic involvement was taken as evidence of disease in ongoing negotiations about the medical and moral status of people with eating disorders. PMID:24286479
Godart, Nathalie; Berthoz, Sylvie; Rein, Zoé; Perdereau, Fabienne; Lang, François; Venisse, Jean-Luc; Halfon, Olivier; Bizouard, Pierre; Loas, Gwénolé; Corcos, Maurice; Jeammet, Philippe; Flament, Martine; Curt, Florence
2006-12-01
The objective of the present work is to determine whether the prevalence of depressive and anxiety disorders varies in subgroups of eating disorders (ED) according to age, ED duration, mode of care provision, and body mass index (BMI). Using the Mini International Neuropsychiatric Interview (MINI), the frequency of anxiety and depressive disorders was evaluated in 271 ED participants. Their prevalence was compared in subgroups of anorexics (AN-R and AN-BN) and bulimics (BN), both before and after controlling for potential confounding variables. Current or lifetime comorbidity of anxiety and depressive disorders did not differ between AN-R and AN-BN groups. Social phobia, panic disorders, and obsessive-compulsive disorder (OCD) were significantly more frequent in AN-BN and AN-R groups. Panic disorder was more frequent in the BN group. Several confounding factors, in particular those identified in the present study, may explain previous conflicting results on the frequency of anxiety and depressive disorders in ED. Nevertheless, the study confirmed that OCD is more frequent in AN, even after controlling for confounding factors. Copyright 2006 by Wiley Periodicals, Inc.
Autoantibodies against α-MSH, ACTH, and LHRH in anorexia and bulimia nervosa patients
Fetissov, Sergueï O.; Hallman, Jarmila; Oreland, Lars; af Klinteberg, Britt; Grenbäck, Eva; Hulting, Anna-Lena; Hökfelt, Tomas
2002-01-01
The hypothalamic arcuate nucleus is involved in the control of energy intake and expenditure and may participate in the pathogenesis of eating disorders such as anorexia nervosa (AN) and bulimia nervosa (BN). Two systems are of particular interest in this respect, synthesizing α-melanocyte-stimulating hormone (α-MSH) and synthesizing neuropeptide Y, respectively. We report here that 42 of 57 (74%) AN and/or BN patients studied had in their plasma Abs that bind to melanotropes and/or corticotropes in the rat pituitary. Among these sera, 8 were found to bind selectively to α-MSH-positive neurons and their hypothalamic and extrahypothalamic projections as revealed with immunostaining on rat brain sections. Adsorption of these sera with α-MSH peptide abolished this immunostaining. In the pituitary, the immunostaining was blocked by adsorption with α-MSH or adrenocorticotropic hormone. Additionally, 3 AN/BN sera bound to luteinizing hormone-releasing hormone (LHRH)-positive terminals in the rat median eminence, but only 2 of them were adsorbed with LHRH. In the control subjects, 2 of 13 sera (16%) displayed similar to AN/BN staining. These data provide evidence that a significant subpopulation of AN/BN patients have autoantibodies that bind to α-MSH or adrenocorticotropic hormone, a finding pointing also to involvement of the stress axis. It remains to be established whether these Abs interfere with normal signal transduction in the brain melanocortin circuitry/LHRH system and/or in other central and peripheral sites relevant to food intake regulation, to what extent such effects are related to and/or could be involved in the pathophysiology or clinical presentation of AN/BN, and to what extent increased stress is an important factor for production of these autoantibodies. PMID:12486250
Godart, N-T; Curt, F; Perdereau, F; Lang, F; Venisse, J-L; Halfon, O; Bizouard, P; Loas, G; Corcos, M; Jeammet, Ph; Flament, M-F
2005-01-01
Our objective was to answer the following question: are there differences between diagnostic groups of eating disorders (ED) for the prevalence of depressive and anxiety disorders, when clinical differences between the groups are taken into account (ie age of subjects, ED duration, inpatient or outpatient status, and Body Mass Index)? We evaluated the frequency of anxiety disorders and depressive disorders in 271 subjects presenting with a diagnosis of either anorexia nervosa or bulimia, using the Mini International Neuropsychiatric Interview (MINI), DSM IV version. We compared the prevalences between sub-groups of anorexics (AN-R and AN-BN), between sub-groups of bulimics (BN-P and BN-NP) and between anorexics and bulimics while adjusting for the variables defined below. Current or lifetime comorbidity of anxiety and depressive disorders did not differ between AN-Rs and AN-BNs, nor between BN-Ps and BN-NPs. Only current diagnoses of agoraphobia and obsessive-compulsive disorder were significantly more frequent in anorexics than in bulimics. The greater frequency of comorbidity between obsessive-compulsive disorder and AN compared to BN, already well documented, is not questioned. The remaining anxiety disorders are equally frequent among all the diagnostic types of ED.
[Clinical characteristics and gender identity among eating disordered patients subtypes].
Behar, Rosa; de la Barrera, Mónica; Michelotti, Julio
2003-07-01
Gender identity is a relevant issue in the approach to eating disorders. To compare psychological and behavioural characteristics and traits of gender identity among women with eating disorders and its subtypes and non eating disordered female subjects. An structured clinical interview based on the DSM-IV diagnostic criteria for eating disorders, the EAT-40 (Eating Attitudes Test), the Eating Disorders Inventory (EDI) and the Bem Sex Role Inventory (IBRS) were administered to 58 compulsive-purgative anorectics (AN/BN group), 15 restrictive anorectics (AN group), 33 patients suffering from eating disorder not otherwise identified, 33 purgative bulimics and to 82 female students without eating disorders. Patients with eating disorders ranked significantly higher on the EAT-40 and EDI and all its items (p < 0.001). The AN/BN group ranked significantly higher on the EDI (p < 0.001) and on Drive for thinness, Perfectionism and interpersonal distrust (p < 0.001). The AN group ranked higher on Maturity fears (p < 0.001). The BN group ranged higher on Body dissatisfaction, Ineffectiveness and Interoceptive awareness (p < 0.001). Patients with eating disorders were significantly identified with Feminine category and subjects without eating disorders with Androgynous and Undifferentiated categories on the IBRS (p = 0.002). The AN group showed the highest percentage on Feminine category and the lowest on Androgynous and Undifferentiated categories. All the groups rejected and approved feminine, masculine and neutral qualities. Femininity emerged as the main trait of gender identity in patients suffering from eating disorders, in contrast to androgyny, showed by healthy women.
Eating disorder symptomatology among ballet dancers.
Ringham, Rebecca; Klump, Kelly; Kaye, Walter; Stone, David; Libman, Steven; Stowe, Susan; Marcus, Marsha
2006-09-01
The current study sought to compare eating disorder symptomatology among ballet dancers and individuals with restricting anorexia nervosa (RAN), bulimia nervosa (BN), and no eating pathology. Twenty-nine female ballet dancers completed assessments and were compared with an archival dataset of 26 women with RAN, 47 women with BN, and 44 women with no eating pathology. Eating disorder diagnoses and behaviors were assessed with a semi-structured clinical interview, the Eating Disorder Inventory (EDI), and a weight history interview. Eighty-three percent of dancers met lifetime criteria for AN (6.9%), BN (10.3%), AN+BN (10.3%), or EDNOS (55.0%). Moreover, dancers looked more similar to eating-disordered individuals than to control individuals on measures of eating pathology. Despite previous emphasis on the pathology AN, the current findings suggest that dancers frequently engage in binge eating and purging behaviors. Moreover, it appears that their pathology is as severe as that of non-dancing women with eating disorders. Copyright (c) 2006 by Wiley Periodicals, Inc.
Farha, Ashraf Hassan; Ozkendir, Osman Murat; Elsayed-Ali, Hani E.; ...
2016-11-15
NbN coatings are prepared onto Nb substrate by thermal diffusion at high temperatures. The formation of NbN coating by thermal diffusion was studied in the range of 1250-1500 °C at constant nitrogen background gas pressure (1.3x10 -3 Pa) and processing time (180 min). The electronic and crystal structures of the NbN coatings were investigated. It was found that nitrogen diffuses into Nb forming the Nb-N solid solution (bcc) a-NbN phase that starts to appear above 1250 °C. Increasing the processing temperature gives richer a-phase concentration. Besides, X-ray absorption spectroscopy (XAS) was performed to study the electronic structure of the NbNmore » layer. The results of the electronic structural study corroborate the crystal structural analysis. The Nb M 3,2 edge X-ray absorption spectroscopy (XAS) spectrum shows strong temperature dependence. At the highest processing temperature (1500 °C), the number of d holes increased. Nitrogen diffusion into Nb is resulting to increase electrostatic interaction between d electron and core hole. Lastly, for the studied conditions, only the α-NbN was observed in the X-ray diffraction patterns.« less
DOE Office of Scientific and Technical Information (OSTI.GOV)
Farha, Ashraf Hassan; Ozkendir, Osman Murat; Elsayed-Ali, Hani E.
NbN coatings are prepared onto Nb substrate by thermal diffusion at high temperatures. The formation of NbN coating by thermal diffusion was studied in the range of 1250-1500 °C at constant nitrogen background gas pressure (1.3x10 -3 Pa) and processing time (180 min). The electronic and crystal structures of the NbN coatings were investigated. It was found that nitrogen diffuses into Nb forming the Nb-N solid solution (bcc) a-NbN phase that starts to appear above 1250 °C. Increasing the processing temperature gives richer a-phase concentration. Besides, X-ray absorption spectroscopy (XAS) was performed to study the electronic structure of the NbNmore » layer. The results of the electronic structural study corroborate the crystal structural analysis. The Nb M 3,2 edge X-ray absorption spectroscopy (XAS) spectrum shows strong temperature dependence. At the highest processing temperature (1500 °C), the number of d holes increased. Nitrogen diffusion into Nb is resulting to increase electrostatic interaction between d electron and core hole. Lastly, for the studied conditions, only the α-NbN was observed in the X-ray diffraction patterns.« less
Roberts, Marion E; Tchanturia, Kate; Treasure, Janet L
2013-08-01
To investigate whether attention to detail is a similarly strong candidate endophenotype of anorexia (AN) and bulimia nervosa (BN), and to explore the incidence and clinical correlates of attention to detail. A total of 266 women (including AN, BN, recovered AN, unaffected sisters of AN/BN & control women) undertook a thorough clinical assessment and were administered two neuropsychological measures of attention to detail (Group Embedded Figure Test; Rey-Osterrieth Complex Figure). Superior attention to detail was found across all AN groups including recovered AN and unaffected AN sisters. Those with BN and their unaffected sisters showed a profile more consistent with poor global integration. The combined effect of superior attention to detail and poor global integration ("weak coherence") was present in 42.3% of active cases and corresponded with a more severe illness, elevated obsessive-compulsive symptoms, and a higher likelihood of comorbid clinical anxiety and self-harm. Attention to detail is a stronger candidate endophenotype of AN compared to BN, where poor global integration may be more relevant. The unique contribution of both aspects of weak coherence (superior attention to detail/poor global integration) requires further exploration and understanding in both eating disorders. Integrating cognitive remediation of these traits into treatment for the subset of patients it is relevant for may improve outcome.
Easter, Abigail; Naumann, Ulrike; Northstone, Kate; Schmidt, Ulrike; Treasure, Janet; Micali, Nadia
2013-07-01
To investigate dietary patterns and nutritional intake in children of mothers with eating disorders. Mothers (N = 9423) from a longitudinal general population birth cohort study, the Avon Longitudinal Study of Parents and Children, completed Food Frequency Questionnaires on their children at 3, 4, 7, and 9 years of age. Macronutrient intake was estimated, and dietary patterns were obtained using principal components analysis. Linear regression and mixed-effects models were used to assess dietary patterns and nutritional intake among children of women with lifetime anorexia nervosa (AN, n = 140), bulimia nervosa (BN, n = 170), or AN+BN (n = 71), compared with children of women without eating disorders (unexposed women, n = 9037). Children in the maternal AN and BN groups had higher scores on the "health conscious/vegetarian" dietary pattern compared with unexposed children. Less adherence to the "traditional" dietary pattern was observed in children of exposed mothers, with more pronounced differences in early childhood. Children of women with AN and BN had higher intake of energy and children of women with BN had higher intake of carbohydrates and starch and lower intake of fat, compared with children in the unexposed group. Maternal eating disorders are associated with altered offspring dietary patterns and macronutrient intake. Longitudinal changes in patterns of diet in children of women with eating disorders may increase the risk of weight gain or disordered eating later in life. Copyright © 2013 Mosby, Inc. All rights reserved.
Bailer, Ursula F; Frank, Guido K; Price, Julie C; Meltzer, Carolyn C; Becker, Carl; Mathis, Chester A; Wagner, Angela; Barbarich-Marsteller, Nicole C; Bloss, Cinnamon S; Putnam, Karen; Schork, Nicholas J; Gamst, Anthony; Kaye, Walter H
2013-02-28
Individuals with anorexia nervosa (AN) and bulimia nervosa (BN) have alterations of measures of serotonin (5-HT) and dopamine (DA) function, which persist after long-term recovery and are associated with elevated harm avoidance (HA), a measure of anxiety and behavioral inhibition. Based on theories that 5-HT is an aversive motivational system that may oppose a DA-related appetitive system, we explored interactions of positron emission tomography (PET) radioligand measures that reflect portions of these systems. Twenty-seven individuals recovered (REC) from eating disorders (EDs) (7 AN-BN, 11 AN, 9 BN) and nine control women (CW) were analyzed for correlations between [(11)C]McN5652 and [(11)C]raclopride binding. There was a significant positive correlation between [(11)C]McN5652 binding potential (BP(non displaceable(ND))) and [(11)C]Raclopride BP(ND) for the dorsal caudate, antero-ventral striatum (AVS), middle caudate, and ventral and dorsal putamen. No significant correlations were found in CW. [(11)C]Raclopride BP(ND), but not [(11)C]McN5652 BP(ND), was significantly related to HA in REC EDs. A linear regression analysis showed that the interaction between [(11)C]McN5652 BP(ND) and [(11)C]raclopride BP(ND) in the dorsal putamen significantly predicted HA. This is the first study using PET and the radioligands [(11)C]McN5652 and [(11)C]raclopride to show a direct relationship between 5-HT transporter and striatal DA D2/D3 receptor binding in humans, supporting the possibility that 5-HT and DA interactions contribute to HA behaviors in EDs. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Cho, Pyeong Whan; Szkudlarek, Emily; Tabor, Whitney
2016-01-01
Learning is typically understood as a process in which the behavior of an organism is progressively shaped until it closely approximates a target form. It is easy to comprehend how a motor skill or a vocabulary can be progressively learned—in each case, one can conceptualize a series of intermediate steps which lead to the formation of a proficient behavior. With grammar, it is more difficult to think in these terms. For example, center embedding recursive structures seem to involve a complex interplay between multiple symbolic rules which have to be in place simultaneously for the system to work at all, so it is not obvious how the mechanism could gradually come into being. Here, we offer empirical evidence from a new artificial language (or “artificial grammar”) learning paradigm, Locus Prediction, that, despite the conceptual conundrum, recursion acquisition occurs gradually, at least for a simple formal language. In particular, we focus on a variant of the simplest recursive language, anbn, and find evidence that (i) participants trained on two levels of structure (essentially ab and aabb) generalize to the next higher level (aaabbb) more readily than participants trained on one level of structure (ab) combined with a filler sentence; nevertheless, they do not generalize immediately; (ii) participants trained up to three levels (ab, aabb, aaabbb) generalize more readily to four levels than participants trained on two levels generalize to three; (iii) when we present the levels in succession, starting with the lower levels and including more and more of the higher levels, participants show evidence of transitioning between the levels gradually, exhibiting intermediate patterns of behavior on which they were not trained; (iv) the intermediate patterns of behavior are associated with perturbations of an attractor in the sense of dynamical systems theory. We argue that all of these behaviors indicate a theory of mental representation in which recursive systems lie on a continuum of grammar systems which are organized so that grammars that produce similar behaviors are near one another, and that people learning a recursive system are navigating progressively through the space of these grammars. PMID:27375543
Barron, Leanne J; Barron, Robert F; Johnson, Jeremy C S; Wagner, Ingrid; Ward, Cameron J B; Ward, Shannon R B; Barron, Faye M; Ward, Warren K
2017-01-01
The objective of the study was to determine whether levels of biochemical and haematological parameters in patients with eating disorders (EDs) varied from the general population. Whilst dietary restrictions can lead to nutritional deficiencies, specific abnormalities may be relevant to the diagnosis, pathogenesis and treatment of EDs. With ethics approval and informed consent, a retrospective chart audit was conducted of 113 patients with EDs at a general practice in Brisbane, Australia. This was analysed first as a total group (TG) and then in 4 ED subgroups: Anorexia nervosa (AN), Bulimia nervosa (BN), ED Not Otherwise Specified (EDNOS), and AN/BN. Eighteen parameters were assessed at or near first presentation: cholesterol, folate, vitamin B12, magnesium, manganese, zinc, calcium, potassium, urate, sodium, albumin, phosphate, ferritin, vitamin D, white cell count, neutrophils, red cell count and platelets. Results were analysed using IBM SPSS 21 and Microsoft Excel 2013 by two-tailed, one-sample t-tests (TG and 4 subgroups) and chi-square tests (TG only) and compared to the population mean standards. Results for the TG and each subgroup individually were then compared with the known reference interval (RI). For the total sample, t-tests showed significant differences for all parameters ( p < 0.05) except cholesterol. Most parameters gave results below population levels, but folate, phosphate, albumin, calcium and vitamin B12 were above. More patients than expected were below the RI for most parameters in the TG and subgroups. At diagnosis, in patients with EDs, there are often significant differences in multiple haematological and biochemical parameters. Early identification of these abnormalities may provide additional avenues of ED treatment through supplementation and dietary guidance, and may be used to reinforce negative impacts on health caused by the ED to the patient, their family and their treatment team (general practitioner, dietitian and mental health professionals). Study data would support routine measurement of a full blood count and electrolytes, phosphate, magnesium, liver function tests, ferritin, vitamin B12, red cell folate, vitamin D, manganese and zinc for all patients at first presentation with an ED.