ABSTRACT Early identification of factors that predict readmission could enhance treatment planning and reduce re-hospitalization. This study evaluated the predictive value of the Eating Disorder Examination-Questionnaire (EDE-Q) for inpatient readmission for adolescents with AN. This retrospective longitudinal study included 226 adolescent participants admitted to an inpatient eating disorder unit. Adolescents completed the EDE-Q within the first 14 days of admission; demographic variables, anxiety and mood comorbidities, and readmission status within 1 year of discharge were obtained through chart review. While higher scores on the EDE-Q global score and subscales for Eating, Shape, and Weight Concerns were significantly associated with readmission, when controlling for demographic variables and length of hospital stay in multivariate regressions, both Eating Concerns and Weight Concerns subscales were trending toward significance (p = .11, p = .06, respectively). Multivariate logistic regression adjusting for demographic variables showed that higher scores on the EDE-Q global score, and Eating Concern, Shape Concern, and Weight Concern subscales were associated with increased odds of comorbid mood or anxiety disorders with an OR of 1.27 (1.03, 1.57), p = .02; OR of 1.47 (CI 1.17, 1.83), p = .001; OR 1.27 (CI 1.05, 1.54), p = .02; and OR 1.22 (CI 1.02, 1.47), p = .03, respectively. These findings underscore how self-report measures like the EDE-Q can highlight more complex psychopathology with regard to comorbidities. Future research with larger sample sizes will be necessary to establish the predictive validity of the EDE-Q for readmissions of adolescents with Anorexia Nervosa.

ABSTRACT Mindfulness, emotion regulation, and distress tolerance are hypothesised mechanisms that underpin Dialectical Behaviour Therapy (DBT) for binge eating, yet their role in app-based interventions is unclear. This study examined whether (1) a digital DBT app improved these skills compared to a control condition and (2) baseline skill levels predicted post-treatment symptom change. This secondary analysis drew on data from a randomised controlled trial (n = 576) of adults with recurrent binge eating. Participants in the intervention (n = 287) completed a six-week self-guided DBT app, while controls (n = 289) were waitlisted. Mindfulness, emotion regulation, and distress tolerance were assessed at baseline, post-test, and 12-week follow-up. Outcomes were binge eating episodes and the Eating Disorder Examination Questionnaire (EDEQ). Linear mixed models tested treatment effects, while univariate and multivariate models assessed baseline predictors. The app produced small-to-moderate improvements in four emotion regulation facets—lack of emotional clarity (d = -0.33), limited strategies (d = -0.22), difficulty with goal-directed behaviour (d = -0.28), and non-acceptance (d = -0.30)—and in the mindfulness facet of observing (d = 0.28). No group differences emerged for distress tolerance. Baseline non-acceptance predicted EDEQ improvement in univariate analyses, but not objective binge eating or multivariate models. A self-guided DBT app may strengthen components of mindfulness and emotion regulation. These results may point towards possible mechanisms through which DBT treatments work. That core DBT skills at baseline were unrelated to outcomes suggesting that they may bear little prognostic value, however may be suitable for broad implementation.

ABSTRACT Research into the factors that drive the development, maintenance, and recovery from eating disorders (EDs) has established that social processes play an integral part in helping or hindering one’s recovery from an ED. In a world where social processes have increasingly moved online, this research aimed to better understand themes within ED recovery content on TikTok. A thematic analysis of n = 312 of the most popular TikTok videos about ED recovery was conducted using a snowball sampling method to find common hashtags related to ED recovery and a codebook to compile deductive and inductive codes. Content related to suicide/self-harm or pro-anorexia beliefs was uncommon across the videos, but four themes were generated from the inductive thematic analysis: recovery milestones, the social nature of ED recovery, bodies as evidence of recovery, and the all-powerful ED. The findings from this research contribute to understandings about the shifting online landscape for ED recovery, where platforms like TikTok are increasingly becoming a source of support and community. The findings of this research will assist individuals in ED recovery and those supporting them when deciding whether engaging with recovery content on TikTok is right for their recovery journey.

ABSTRACT The present study aimed to comprehensively evaluate the psychometric properties and clinical utility of the revised Eating Disorder Core Beliefs Questionnaire (ED-CBQ-R) in a clinical sample of individuals seeking treatment for an eating disorder (ED), as well as to examine potential differences in ED core beliefs across distinct diagnostic groups. Treatment-seeking adults (N =150) were recruited from specialist ED private practices throughout Australia and New Zealand, as a part of the Clinical Quality Registry for Eating Disorder Treatment (the “TrEAT Registry”, Australian Register of Clinical Registries: #ACSQHC-ARCR-279). Further, undergraduate data (N = 294) was collected at T1 and T2 (after a four-week interval) to examine test-retest reliability of the ED-CBQ-R. In the treatment-seeking sample, the total ED-CBQ-R, Self-loathing, Unassertive, Demanding and Abandoned subscales displayed good internal consistency, discriminative ability, and the four-factor structure showed acceptable to good fit. Treatment-seeking participants displayed significantly higher scores on all ED-CBQ-R subscales than those in the undergraduate sample. There were no significant differences on the ED-CBQ-R between diagnostic groups, except for the AN-R group displaying higher self-loathing than those with BED. Finally, the ED-CBQ-R demonstrated good test-retest reliability in the undergraduate sample. The outcomes of the present study support the validity, reliability, and clinical utility of the ED-CBQ-R in those seeking treatment for an ED and supports researchers and clinicians in utilising the ED-CBQ-R to identify and monitor critical cognitive targets for treatment and guide clinical decision making.

ABSTRACT This acceptability and feasibility study utilized a mixed methods approach to examine patient and clinician perspectives on telehealth across multiple eating disorder presentations and evidence-based treatment modalities. Youth ages 6–19 received psychotherapy for eating disorders in an outpatient specialty clinic. The Telehealth Expectations Questionnaire (TEQ) assessed baseline expectations of telehealth. Satisfaction with telehealth was assessed monthly through the Telehealth Satisfaction Questionnaire (TSQ). Experiences with telehealth were measured at end of treatment through the Telehealth Usability Questionnaire (TUQ) and Implementation of Telehealth Treatment Questionnaire. The Eating Disorder Examination Questionnaire (EDE-Q) measured clinical improvement. Use of telehealth services was associated with clinically significant reductions in eating disorder symptoms. Qualitatively, patients and families reported advantages of telehealth, specifically saving time and ease of use, and identified disadvantages, including technological difficulties and feeling disconnected from therapists. Clinicians reported benefits of telehealth, such as insight into the home environment, and challenges, such as managing distractions and reading body language. Clinicians identified specific adaptations for telehealth when conducting one-on-one time with patients and taking weights. The perspectives of youth, families, and clinicians highlight important clinical considerations in the utilization of telehealth to promote accessible and effective care for eating disorders.

ABSTRACT Early intervention is key to improving prognosis for youth with eating disorders (EDs). Caregiver groups may be an effective way to intervene early in the treatment of youth with EDs, in conjunction with speciality medical care. A 12-session online caregiver skills group (CARE Skills Group) was designed and offered to caregivers of youth with recent onset, newly diagnosed restrictive EDs at two different Canadian sites. The CARE Skills group integrated family-based treatment (FBT) principles and was led by experienced ED clinicians. The group was feasible, with some preliminary evidence that youth whose caregivers participated in the CARE Skills Group benefited in terms of weight restoration. The CARE Skills Group model represents a brief, and replicable early intervention model that has potential utility for implementation in community-based ED settings.

ABSTRACT Eating disorders (EDs) are prevalent mental health conditions that occur globally and affect all population subgroups. Despite their severity and widespread impact, EDs are frequently underdiagnosed and undertreated, particularly among individuals from minoritized racial and ethnic backgrounds, and groups that have been historically excluded from ED research. Early intervention (EI) has been shown to improve outcomes by reducing untreated illness duration, yet its implementation remains limited. This commentary examines patient-, clinician-, and systemic-level barriers to the timely detection and treatment of EDs, with an emphasis on how these barriers impact individuals from minoritized backgrounds. Evidence-based strategies to improve access to EI are also discussed as pathways to more equitable and effective care. Increasing access to EI and culturally informed treatments is essential to mitigating the burden of EDs and improving outcomes across populations.

ABSTRACT We examined associations between potentially traumatic events (PTEs) and lifetime eating disorders (EDs) in the Eating Disorders Genetics Initiative-Mexico [EDGI-MX; N = 298; 174 cases, 124 controls, ages 13–78 years (M = 28.9 SD = 11.3), 81% cisgender women].ED diagnoses and symptoms were from an online questionnaire capturing DSM-5 diagnoses via algorithm; PTEs were assessed with the Life Events Checklist for DSM-5; and depression, anxiety, and obsessive-compulsive (OC) symptoms with validated self-report measures. Logistic regressions and analyses of covariance were adjusted for age and gender. PTEs were reported by 75% of cases and 53% of controls (adjusted odds ratio [aOR] 3.6; 95% confidence interval [CI] 2.04, 6.62), including fire/explosions (13.6; 1.30, 141.76), transportation accident (2.1; 1.13, 4.06), serious accidents (10.0; 2.03, 49.64), sexual assault (5.9; 2.57, 13.91), other uncomfortable sexual experiences (3.2; 1.68, 6.41), and other stressful event (4.3; 1.95, 9.76). Although PTEs were not significantly associated with greater depression, anxiety, or OC symptoms in cases, these co-occurring symptoms may still be relevant clinically. Results highlight the importance of assessing PTEs in Mexican individuals with EDs and encourage exploration of timing of PTE exposure to clarify their role in ED development and course.

ABSTRACT Recent prospective studies identified risk factors that predict future onset of anorexia nervosa (AN), but none have differentiated between those predicting restrictive (AN-R) versus binge-eating/purging (AN-BP) AN subtypes. Identifying shared versus unique risk factors may clarify whether these subtypes reflect distinct subtypes of AN or phases of the same disorder. This exploratory study combined data from four eating disorder prevention trials involving young women at risk for eating disorders (N = 1,952, mean age = 19.7 years) and collected annual diagnostic data over a 3-year follow-up. We assessed which baseline variables predicted future onset of AN-R and AN-BP, including subthreshold cases classified as Other Specified Feeding and Eating Disorder. Over 3-year follow-up, 34 participants developed AN-R and 24 developed AN-BP. Elevated negative affect and low BMI emerged as shared risk factors for both AN subtypes. Unique risk factors for AN-R were elevated thin-ideal internalization, fear of weight gain, and dietary restraint. Psychosocial impairment was the only unique predictor for AN-BP. The presence of distinct risk factors suggests that AN-R and AN-BP represent distinct subtypes rather than developmental stages of the same disorder. Shared risk factors should be prioritized as targets in prevention efforts for AN, particularly negative affect, and low prodromal BMI.

ABSTRACT Dialectical behaviour therapy (DBT) has a developing evidence base for treating complex multi-diagnostic eating disorder presentations, including for individuals with long-standing eating disorders. A retrospective analysis of pre- and post-test data collected at 12 months from 16 adult participants in a “DBT for Multi-diagnostic Eating Disorders” (MED-DBT) programme run in New Zealand was conducted. Psychological outcomes were assessed using the Depression, Anxiety and Stress Scale-21 (DASS-21) and Difficulties with Emotion Regulation Scale (DERS). Clinical indicators consisted of body mass index (BMI) and scores on the Eating Disorder Examination Questionnaire (EDE-Q). Significant differences were found for difficulties with emotion regulation scores (U = 8.571, p = .007), eating disorder examination questionnaire global scores (U = 47.5, p = .003), and anxiety scores (U = 42.0, p = .040), favouring those who completed the 12 months of the MED-DBT programme including the skills group. No significant differences were found for depression or stress symptoms. BMI increased for those who completed 12 months of the programme (Mdn = 1.265) and decreased (Mdn = -.580; U = 6.0, p = .019) for non-completers. The findings suggest that completing 12 months of MED-DBT including the group component may result in clinically meaningful change when compared to non-completion. Although participants were still experiencing eating disorder symptoms at the end of 12 months, these were significantly reduced and were paired with improved emotional wellbeing.