Binge Eating Frequency Research Articles

Online dialectical behavior therapy for binge eating disorder: an open trial.

The purpose of the present study was to examine the efficacy of online Dialectical Behavior Therapy for Binge Eating Disorder (DBT-BED) in reducing eating psychopathology and investigate the factors that influence the severity and frequency of binge eating. Seventy-three individuals seeking treatment for BED participated in 20 two-hour group sessions. Participants completed the Emotional Eating Scale (EES), Binge Eating Scale (BES), and Eating Disorder Examination Questionnaire (EDE-Q) before and after the treatment and at three- and six-month follow-ups. Results from 58 participants were analyzed. The study results indicated a significant decrease in objective binge eating (OBE) days, as well as in all EES, BES, and EDE-Q subscales (except the Restraint subscale), and global EDE-Q score at the end of treatment and follow-ups. Moreover, the Body Mass Index (BMI) reduced at the end of treatment and during the follow-up period. Except for the Restraint subscale, more OBE days were linked with higher EES, BES, and EDE-Q scores. Overall, the study suggests that online DBT-BED is an effective approach to treating Binge Eating Disorder (BED) for individuals who cannot receive in-person therapy. Further research is necessary to compare the efficacy of online DBT-BED with other interventions.

Purging frequency and number of purging methods as indicators of severity in bulimia nervosa: Interactive effects with binge eating episodes.

In the Diagnostic and Statistical Manual of Mental Disorders-5, severity of bulimia nervosa (BN) is defined by the frequency of purging behaviour. Previous research suggests the number of purging methods as an alternative rating. The current analysis investigated characteristics (sociodemographic and treatment-related variables, body mass index [BMI], eating disorder-specific and general psychopathology) of persons with BN as a function of purging frequency and number of purging methods in order to examine which approach might be better suited for indicating severity of BN. Two-hundred and sixty-one persons (98.5% female; mean age 25.2years, SD=9.41; mean BMI 22.0kg/m2, SD=3.79) with BN completed self-report questionnaires on eating disorder-specific and general psychopathology at admission to inpatient (n=214) or daypatient (n=47) treatment. Higher severity based on either purging frequency or number of purging methods tended to relate to lower BMI and higher eating disorder-specific and general psychopathology. In addition, binge-eating frequency differentially related to eating disorder-specific and general psychopathology as a function of severity groups. This study partially supports the utility of both purging frequency and the number of purging methods as indicators of severity in persons with BN. However, focussing only on purging behaviours may be short-sighted as it appears necessary to consider the number of binge-eating episodes as well when evaluating severity of BN.

Suicidal thoughts and attempts in a transdiagnostic eating disorder sample: Do diagnostic severity criteria predict risk?

Eating disorders (EDs) are associated with elevated suicide. Low body mass index (BMI) and frequency of purging and binge eating represent severity criteria for EDs and distinguish full-threshold EDs from other specified feeding and eating disorders (OSFED). However, no work has taken a transdiagnostic approach to studying whether severity of these or other features is associated with suicidal ideation (SI) and attempts. We examined diagnostic status, ED features, and SI and attempts in a large, transdiagnostic, community sample of 257 women with EDs and 45 controls without a current or past ED in the United States using the EDs Examination interview and the Structured Clinical Interview for the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). SI and suicide attempts (SA) were elevated in OSFED compared to controls but did not differ between OSFED and full-threshold EDs. Higher BMI predicted increased SI. Number of purging methods, but not frequency, was related to history of SA. Binge episode frequency and size were not significant predictors. OSFED presents with elevated SI and SA, and ED severity criteria that distinguish OSFED from full-threshold EDs do not predict SI or SA. Suicide risk assessments should be implemented universally across EDs in clinical practice.

Lisdexamfetamine maintenance treatment for binge-eating disorder following successful treatments: randomized double-blind placebo-controlled trial.

Controlled research examining maintenance treatments for responders to acute interventions for binge-eating disorder (BED) is limited. This study tested efficacy of lisdexamfetamine (LDX) maintenance treatment amongst acute responders. This prospective randomized double-blind placebo-controlled single-site trial, conducted March 2019 to September 2023, tested LDX as maintenance treatment for responders to acute treatments with LDX-alone or with cognitive-behavioral therapy (CBT + LDX) for BED with obesity. Sixty-one (83.6% women, mean age 44.3, mean BMI 36.1 kg/m2) acute responders were randomized to LDX (N = 32) or placebo (N = 29) for 12 weeks; 95.1% completed posttreatment assessments. Mixed-models and generalized-estimating equations comparing maintenance LDX v. placebo included main/interactive effects of acute (LDX or CBT + LDX) treatments to examine their predictive/moderating effects. Relapse rates (to diagnosis-level binge-eating frequency) following maintenance treatments were 10.0% (N = 3/30) for LDX and 17.9% (N = 5/28) for placebo; intention-to-treat binge-eating remission rates were 59.4% (N = 19/32) and 65.5% (N = 19/29), respectively. Maintenance LDX and placebo did not differ significantly in binge-eating but differed in weight-loss and eating-disorder psychopathology. Maintenance LDX was associated with significant weight-loss (-2.3%) whereas placebo had significant weight-gain (+2.2%); LDX and placebo differed significantly in weight-change throughout treatment and at posttreatment. Eating-disorder psychopathology remained unchanged with LDX but increased significantly with placebo. Acute treatments did not significantly predict/moderate maintenance-treatment outcomes. Adults with BED/obesity who respond to acute lisdexamfetamine treatment (regardless of additionally receiving CBT) had good maintenance during subsequent 12-weeks. Maintenance lisdexamfetamine, relative to placebo, did not provide further benefit for binge-eating but was associated with significantly better eating-disorder psychopathology outcomes and greater weight-loss.

Habitual behavioural control moderates the relation between daily perceived stress and purging.

Evidence suggests that interpersonal stress plays a role in maintaining binge eating and purging (e.g., self-induced vomiting, misuse of laxatives). Stress is especially likely to promote engagement in maladaptive behaviour if the behaviour is habitual; therefore, individuals whose binge eating and/or purging are habitual may be particularly likely to engage in these behaviours in the context of interpersonal stress. We aimed to investigate this hypothesis in a sample of women with binge eating and/or purging using ecological momentary assessment (EMA). Women (N=81) with binge-eating and/or purging symptoms completed a self-report measure assessing habit strength of binge eating and purging followed by a 14-day EMA protocol assessing daily perceived interpersonal stress and binge-eating and purging episodes. Habit strength of purging moderated the within-person effect of interpersonal stress on purging frequency, such that higher daily stress was associated with greater same-day purging frequency when purging was more habitual. Contrary to expectations, the interactive effect of habit strength of binge eating and daily interpersonal stress on same-day binge-eating frequency was non-significant. Findings suggest that individuals with habitual purging may be vulnerable to engaging in purging when they are experiencing high levels of interpersonal stress.

Behaviourally assessed negative urgency is uniquely associated with binge-eating frequency.

Binge eating appears to be associated with impulsivity, especially in response to negative affect (i.e., negative urgency). However, negative urgency is typically assessed via self-report, which captures only some aspects of urgency and may be subject to bias. Few studies have examined impulsivity following experimental manipulations of affect in binge-eating samples. In the present study, individuals who engage in regular binge eating completed a behavioural impulsivity (go/no-go) task with high- and low-calorie food stimuli, once following negative affect induction and once following neutral affect induction. Greater behavioural impulsivity to high-calorie food cues while in a negative (and not a neutral) affective state was associated with more frequent binge-eating behaviour. Further, this behavioural measure of negative urgency uniquely accounted for variance in binge-eating frequency when controlling for self-reported negative urgency, suggesting that behavioural measures may be a useful complement to self-report measures. These findings provide novel and compelling evidence for the relationship between negative urgency and binge eating, highlighting negative urgency as a potentially important target for intervention.

Behavioral weight loss treatment for adults with binge-eating disorder: A qualitative analysis of patients' perspectives and experiences.

Understanding the perspectives of behavioral weight loss (BWL) participants could inform whether, how, and for whom BWL should be offered. All 126 participants in a clinical trial of BWL for adults with binge-eating disorder (BED) and overweight/obesity were contacted about a qualitative study. 45 participants, 11 of whom had dropped out of the parent study, completed qualitative interviews. The interview guide was developed using data from a survey of providers who offer Health at Every Size and other weight-neutral lifestyle interventions. Questions were phrased to invite even the most negative responses. Questions focused on participants' experiences of weight stigma during treatment, perceptions of BWL's calorie and WL goals, and opinions of BWL and weight-neutral interventions. We identified four themes using thematic analysis: (1) BWL did not perpetuate weight stigma. (2) Calorie and WL goals did not exacerbate participants' binge eating. (3) Patients should have the right to pursue any treatment that aligns with their personal goals. (4) BWL can improve participants' overall health. BWL participants with BED and overweight/obesity want others to have access to a program that can reduce both weight and binge eating. Participants emphasized that no treatment works for everyone, and they all agreed that BWL had not perpetuated weight stigma. Fewer than 20% of participants considered the program's calorie and WL goals to be harmful; most participants viewed those goals as achievable and helpful, and many asserted that their participation in BWL had improved their overall health. We interviewed adults with binge-eating disorder and overweight/obesity who had participated in a behavioral weight loss (BWL) program. Our participants wanted others in their position to have access to BWL because it aims to reduce both weight and binge-eating frequency. Efforts should be made to provide patients, clinicians, and policymakers with the knowledge that supervised, evidence-based BWL is an effective and desired treatment choice for this population.

An examination of state and trait urgency in individuals with binge-eating disorder.

Negative urgency (i.e., acting rashly when experiencing negative affect; NU), is a theorised maintenance factor in binge-eating type eating disorders. This study examined the association between trait NU and eating disorder severity, momentary changes in state NU surrounding episodes of binge eating, and the momentary mechanistic link between affect, rash action, and binge-eating risk. Participants were 112 individuals with binge-eating disorder (BED). Baseline measures included the UPPS-P Impulsive Behaviour Scale to assess trait NU and the Eating Disorders Examination to assess binge-eating frequency and global eating disorder severity. Ecological momentary assessment captured real-time data on binge eating, negative affect, and state NU. Multiple regression analysis revealed a strong association between trait NU and eating disorder severity. Generalised estimating equations showed that state NU increased before and decreased after binge-eating episodes, and that this pattern was not moderated by trait-level NU. Finally, a multilevel structural equation model indicated that increases in rash action mediated the momentary relationship between states of high negative affect and episodes of binge eating. These findings underscore the importance of both trait and state NU in binge-eating type eating disorders, and suggest NU as a potential key target for intervention.

Eating Disorder Symptomatology Among Young Adult Cigarette and E-Cigarette Users

Objective: Tobacco use is elevated among individuals with eating disorders (EDs). Yet, further research is needed to understand associations between cigarette and e-cigarette use patterns and ED symptomatology. To gain a more comprehensive understanding of tobacco use and EDs, this study characterized ED symptomatology and tobacco use patterns, including exclusive cigarette use, e-cigarette use, dual use, and nonuse. Method: Young adults aged 18-24 years who self-reported exclusive cigarette, e-cigarette, dual, or nonuse (N = 2500) were recruited via Lucid, an online survey management company. Participants completed questionnaires assessing body dissatisfaction, global ED psychopathology, binge eating and self-induced vomiting frequency, and demographics. ED diagnostic groups included: anorexia nervosa (AN), bulimia spectrum eating disorders (BSED), atypical AN, and night eating syndrome (NES). Results: Multinomial logistic models revealed those with AN were more likely to be dual users, those with atypical AN were more likely to be exclusive e-cigarette users, and participants with a BSED or NES were more likely to be exclusive e-cigarette or dual users, compared to those without an ED. General linear models suggested body dissatisfaction and global ED psychopathology were higher among exclusive e-cigarette and dual users, while binge eating and self-induced vomiting frequencies were greater among all tobacco use groups compared to nonusers. Discussion: Our findings suggest young adults with ED symptomatology were more likely to be users of e-cigarettes exclusively or dual users. It will be necessary to examine how these associations manifest using longitudinal and clinical populations in future research.

Momentary appearance focused self-concept is associated with dietary restraint and binge eating in female university students: An experience sampling study.

Appearance focused self-concept (i.e., overvaluing the importance of appearance for self-definition and self-worth) is theorized to predict dietary restraint and binge eating in the short-term (e.g., daily life). Yet, no research has examined whether appearance focused self-concept increases within-persons during a day and if such increases are linked to greater dietary restraint and binge eating for that day. We addressed this gap in knowledge. Sixty-three female university students completed four items from the Beliefs About Appearance Scale as a measure of appearance focused self-concept six times per day (9 am, 11 am, 1 pm, 3 pm, 5 pm, and 7 pm) for 14 days. Daily at 9 pm, they completed measures of dietary restraint and binge eating for that day. Analyzing data from 555 days, latent growth curve analyses revealed a small-to-moderate linear increase in appearance focused self-concept from 9 am to 3 pm that plateaued from 3 to 7 pm. A more rapid linear increase in appearance focused self-concept from 9 am to 3 pm was associated with greater binge-eating frequency during that day, but not with dietary restraint. The findings were observed when adjusting for between-day appearance focused self-concept at 9 am, which was positively associated with dietary restraint and binge-eating frequency. Findings are discussed in relation to research on appearance focused self-concept as a risk factor for disordered eating. Findings are also discussed in relation to how sociocultural factors may increase appearance focused self-concept over time. Future research should delve into the within-day dynamic interplay between appearance focused self-concept and disordered eating. Our study revealed a noteworthy increase in the importance women attach to their appearance over the course of a day, correlating with increased binge eating during that day. Additionally, heightened appearance importance at the onset of a day was associated with more dietary restraint and binge eating during that day. These findings suggest a shorter timescale for the connection between appearance importance and disordered eating than previously understood.

Preconception weight suppression predicts eating disorder symptoms in pregnancy.

Disordered eating is common in pregnancy and associated with adverse health outcomes. Weight suppression (WS), the discrepancy between highest lifetime and current weight, is a robust predictor of loss of control (LOC) and binge eating and weight gain trajectories in clinical populations. This study explored the role of preconception WS as a predictor of disordered eating and weight gain in pregnancy. Pregnant individuals (n=137) reported their highest, preconception, and current weights to calculate preconception WS, actual gestational weight gain (GWG), and deviations from recommended weight gain trajectories in pregnancy. Participants also completed the Prenatal Eating Behaviours Screening (PEBS) tool, a validated measure of disordered eating specifically in pregnancy. Preconception WS was a significant predictor of PEBS total scores [F(5, 122)=2.70, p=0.02, R2=0.10] and significantly and positively correlated with individual item scores quantifying restrictive eating behaviours. Preconception WS was not predictive of deviations from recommended GWG trajectories or LOC or binge eating frequency and did not interact with pre-pregnancy body mass index or GWG to predict eating disorder symptom severity. Preconception WS was predictive of disordered eating, and specifically restrictive eating behaviours in pregnancy, and should be assessed as part of screening for eating disorder risk in pregnant individuals.

Overvaluation of shape/weight at posttreatment predicts relapse at 12-month follow-up after successful behaviorally-based treatment of binge-eating disorder.

To test whether overvaluation of shape/weight at the end of treatment prospectively predicts relapse at 12-month follow-up in patients with binge-eating disorder (BED). Participants were 129 patients with BED who achieved abstinence from binge eating after 6 months of behaviorally-based weight-loss treatments in a clinical trial. Independent assessments conducted at posttreatment and at 12-month follow-up included the Eating Disorder Examination interview, the Beck Depression Inventory, and weight measurements. Of the 129 participants who attained abstinence from binge-eating at posttreatment, 46 (36%) were categorized with clinical overvaluation and 83 (64%) with subclinical overvaluation; 115 (89%) were re-assessed at 12-month follow-up. Participants with overvaluation at posttreatment were significantly more likely than those without to relapse at 12-months to non-abstinence from binge eating (54% vs. 28%) and to diagnosis-level binge-eating frequency of once weekly or greater (31% vs. 13%). Overvaluation at posttreatment predicted significantly higher eating-disorder psychopathology and depression scores at 12-month follow-up but were unrelated to weight and weight changes. Treatment groups did not have main or interaction effects; posttreatment overvaluation effects were observed regardless of treatment and of covarying for posttreatment value of dependent variables. Our findings suggest that overvaluation of shape/weight at the end of treatment predicts relapse and heightened eating-disorder psychopathology and depression scores 1 year later in patients who achieved abstinence from binge eating with behaviorally-based treatments. Overvaluation of shape/weight has significant clinical implications and warrants consideration as a diagnostic specifier for BED as it provides important prospective prognostic information. Although effective treatments are available for binge-eating disorder, relapse following successful treatments is not uncommon. Almost nothing is known about what predicts relapse following treatments for binge-eating disorder. Our study found that overvaluation of shape/weight (i.e., body image concerns that overly impact self-worth) at posttreatment prospectively predicted relapse and higher eating-disorder psychopathology and depression 1 year later in patients who achieved binge-eating abstinence with behaviorally based treatments. gov registration: NCT00829283. (Treatment of obesity and binge eating: Behavioral weight loss vs. stepped care.).

The children of parents who receive treatment for binge-eating disorder experience improvements in disordered eating.

Parental eating disorders are associated with disordered eating behaviors and psychopathology in their children, but it is not known whether parent treatment for binge-eating disorder (BED) is associated with changes in child disordered eating behaviors and weight. Benefits or the "ripple" effect of treatment on untreated family members has been described in the obesity literature but not for BED. Participants evaluated for two randomized clinical trials for BED were screened for whether they had children. 76 parents completed baseline assessments about a school-aged child; 62 were randomized to treatment, of whom 41 completed end-of-treatment assessments about their child's eating behaviors and weight (which were not targeted in the parent treatments). Analyses revealed a significant effect of time on children's binge-eating frequency and perceived weight category and a significant effect of parent medication on perceived weight category. Parental change in binge eating was associated significantly with changes in child secretive eating and food hoarding. Parental change in weight was not associated significantly with change in age/sex-normed child BMI percentile, but had some associations with parent-perceived child weight category. Parent changes during their treatment were associated with changes in their children. Future longitudinal research is needed to examine when disordered eating emerges and clarify critical intervention timing related to children's age and parental BED. Further clinical research is also needed to assess the effectiveness of treating disordered eating at the family level. Prior cross-sectional work has found that parents with BED are more likely to have children who engage in binge eating compared to parents without eating-disorder psychopathology. This study was an initial exploration of change in children when parents received treatment in randomized controlled trials for BED. In this study, parent changes in binge eating were associated with reduced child secretive eating and food hoarding.

Neurocognitive reward processes measured via event-related potentials are associated with binge-eating disorder diagnosis and ecologically-assessed behavior

Altered reward processing has been implicated in the onset and maintenance of binge-eating disorder (BED). However, it is unclear which precise neurocognitive reward processes may contribute to BED. In the present study, 40 individuals with BED and 40 age-, sex-, and BMI-matched controls completed a reward (incentive delay) task while their neural activity was recorded using electroencephalography (EEG). Individuals with BED also completed a 10-day ecological momentary assessment (EMA) protocol assessing binge-eating behavior in the natural environment. Event-related potential (ERP) analysis of the EEG indicated that individuals with BED had stronger anticipatory (CNV) and outcome-related (RewP) neural reward activity to food and monetary rewards, compared to controls. However, within the BED group, greater frequency of binge eating during the EMA protocol was associated with stronger anticipatory (CNV) but weaker outcome-related (RewP) neural reward activity. These associations within the BED group were unique to food, and not monetary, rewards. Although preliminary, these results suggest that both anticipatory (“wanting”) and outcome (“liking”) reward processes may be generally amplified in BED. However, they also suggest that among individuals with BED, disorder severity may be associated with increased anticipatory reward processes (“wanting”), but relatively decreased reward-outcome processing (“liking”), of food rewards specifically.

Trajectories of therapeutic skills use and their dynamic relations to symptom change during cognitive-behavioral therapy for bulimia nervosa.

To examine trajectories of therapeutic skills use and weekly relations between skills use and symptom change during the enhanced version of cognitive-behavioral therapy (CBT-E) for bulimia nervosa (BN). Fifty-five adults (M age: 39.0 ± 14.1; 83.9% female; 64.3% White, 93.6% non-Hispanic/Latino) receiving CBT-E for BN-spectrum eating disorders (EDs) self-monitored their use of five therapeutic skills (i.e., regular eating, eating enough to prevent excessive hunger and eating a range of macronutrients, breaking dietary rules, urge management strategies, and mood management strategies) several times per day during treatment. Patients also self-reported their ED symptoms (i.e., frequency of binge eating, compensatory behaviors, and dietary restraint) weekly. We examined trajectories of use of each CBT-E skill and temporal relations between skills use and ED symptoms from week-to-week during treatment. Participants showed significant increases in eating enough to prevent excessive hunger and eating a range of macronutrients from week-to-week (p < .05). Regular eating, eating enough to prevent excessive hunger, and eating a range of macronutrients 1 week predicted lower binge eating and compensatory behaviors the same week and the following week, and urge management strategy use predicted greater binge eating the same week and the following week (p < .05). Results showed temporal relationships between therapeutic skills use and symptom change on a weekly level, with evidence that using skills targeting dietary restraint was associated with lower BN symptoms. Findings highlight the promise of future work to elucidate the most potent CBT-E skills for symptom improvement and inform more targeted interventions. Findings showed weekly relationships between therapeutic skills use and symptom change during treatment, with evidence that using CBT-E skills aimed to reduce dietary restraint (i.e., regular eating, eating enough to prevent excessive hunger, and eating a range of macronutrients) was associated with lower BN symptoms. Future work has the potential to identify the most potent CBT-E skills for symptom improvement and inform more targeted interventions.

The improvement effect of food additive analysis in patients with anorexia nervosa

BackgroundAnorexia nervosa is a severe psychological disorder, and current treatment of anorexia nervosa relies on psychotherapy and medical nutritional support. The study applied food additives to the relevant treatment, aiming to help improve the patients’ diet.Subjects and MethodsPatients who met the diagnostic criteria of anorexia nervosa were randomly selected and divided into experimental and control groups, with 25 patients in each group. The experimental group received food additive-assisted treatment, while the control group received only conventional treatment. Before and after treatment, the patients’ body mass index (BMI) and height were measured, and eating disorders were assessed using the EDE-Q. The resultant data were analyzed using SPSS22.0.ResultsAfter treatment, the BMI of the experimental group was significantly higher than that before treatment (F=18.42, P&lt;0.05), while the BMI of the control group did not change significantly (F=9.71, P&gt;0.05). In the EDE-Q scale assessment, the experimental group scored lower than the control group in terms of frequency of binge eating, frequency of emesis, and restriction of eating factor, and the difference was statistically significant (P&lt;0.05).ConclusionsAfter treatment, patients in the experimental group showed a significant increase in BMI, and the frequency of binge eating, frequency of emetic, and restriction of eating factor scores were lower than those of the control group. This suggests that food additives may have potential efficacy in alleviating the symptoms of anorexia nervosa.

Predictors of neurofeedback treatment outcome in binge-eating disorder: An exploratory study.

Knowledge on predictors for treatment response to psychotherapy in binge-eating disorder (BED) is mixed and not yet available for increasingly popular neurofeedback (NF) treatment targeting self-regulation of aberrant brain activity. This study examined eating disorder- and psychopathology-related predictors for NF treatment success in BED. Patients with BED (N = 78) were randomized to 12 sessions of real-time functional near-infrared spectroscopy (rtfNIRS)-NF, targeting individual prefrontal cortex signal up-regulation, electroencephalography (EEG)-NF, targeting down-regulation of fronto-central beta activity, or waitlist (WL). The few studies assessing predictors for clinical outcomes after NF and evidenced predictors for psychotherapy guided the selection of baseline eating disorder-related predictors, including objective binge-eating (OBE) frequency, eating disorder psychopathology (EDP), food cravings, and body mass index (BMI), and general psychopathology-related predictors, including depressive and anxiety symptoms, impulsivity, emotion dysregulation, and self-efficacy. These questionnaire-based or objectively assessed (BMI) predictors were regressed on outcomes OBE frequency and EDP as key features of BED at post-treatment (t1) and 6-month follow-up (t2) in preregistered generalized mixed models (https://osf.io/4aktp). Higher EDP, food cravings, and BMI predicted worse outcomes across all groups at t1 and t2. General psychopathology-related predictors did not predict outcomes at t1 and t2. Explorative analyses indicated that lower OBE frequency and higher self-efficacy predicted lower OBE frequency, and lower EDP predicted lower EDP after the waiting period in WL. Consistent with findings for psychotherapy, higher eating disorder-related predictors were associated with higher EDP and OBE frequency. The specificity of psychopathological predictors for NF treatment success warrants further examination. This exploratory study firstly assessed eating disorder- and psychopathology-related predictors for neurofeedback treatment outcome in binge-eating disorder and overweight. Findings showed an association between higher eating disorder symptoms and worse neurofeedback outcomes, indicating special needs to be considered in neurofeedback treatment for patients with a higher binge-eating disordersymptom burden. In general, outcomes and assignment to neurofeedback treatment may be improved upon consideration of baseline psychological variables.

Effect of interpersonal conflicts and the moderating effect of the dispositional need to belong on binge eating

The dispositional need to belong (dNTB) is a stable desire to connect with others and belong to groups. Recently, it has been stated that dNTB can alter immediate post-interpersonal conflict behavior. Interpersonal conflict stress is one of the triggers of binge eating. An individual's vulnerability to binge eating in response to interpersonal conflicts before it becomes a disorder has not been investigated from the perspective of the interaction between interpersonal conflict and dNTB. We conducted two studies examining the relationships between interpersonal conflicts and dNTB and the frequency of binge eating behavior in daily life. Conflicting predictions have been made about whether people with a high dNTB eat more after interpersonal conflict than those with a low dNTB. In Study 1, 199 university students answered the survey concerning their dNTB and frequency of interpersonal conflict and binge eating. The results revealed that higher dNTB is associated with more frequent binge eating when individuals face interpersonal conflict. In Study 2, 416 adults throughout Japan participated in the same survey; the results replicated those from Study 1. For exploratory purposes, mental health and other eating behaviors (restrained, emotional, and external eating) were measured in Studies 1 and 2, respectively. However, the moderation effects of dNTB on these eating behaviors were not observed. Previous studies suggested that individuals with a low dNTB ate more in response to social exclusion. This might be due to an immediate interpersonal stress reaction to social exclusion. Conversely, this study's results implicate that the modulation effects of dNTB on excessive eating habits are different from those immediately following interpersonal conflict.

Traditional versus virtual partial hospital programme for eating disorders: Feasibility and preliminary comparison of effects.

Minimal research has examined teletherapy for group or intensive eating disorder (ED) treatment, particularly partial hospital programme (PHP). This study compared treatment outcomes for individuals treated before and after a pandemic-driven implementation of virtual PHP. Patients received care at ED treatment centres using the Renfrew Unified Treatment for Eating Disorders and Comorbidity. Patients treated with virtual PHP were compared to patients treated with traditional PHP. Measures of ED symptomology and behaviours, depressive symptoms, anxiety severity, anxiety sensitivity, experiential avoidance, mindfulness, and body mass index (BMI; reported for anorexia nervosa [AN] patients only) were collected at intake and discharge. Multiple regression analyses were conducted to examine the effect of treatment group on outcomes, controlling for intake score, comorbidity, discharge status, AN diagnosis, and step-down status. Differences in treatment type were only found for binge eating frequency, with those in virtual PHP reporting significantly lower binge eating episodes at discharge than those in traditional PHP. Body mass index showed significantly less improvement in virtual PHP than in traditional PHP. Preliminary results suggest virtual PHP is feasible and effective, potentially increasing access to evidence-based, intensive ED treatment. However, additional research is needed to establish efficacious support for weight gain among individuals with AN in virtual programs.

Comparing self-harming intentions underlying eating disordered behaviors and nonsuicidal self-injury: Replication and extension in adolescents.

Eating disorder (ED) behaviors are often characterized as indirect forms of self-harm. However, recent research has found less clear demarcations between direct self-harming behaviors (e.g., nonsuicidal self-injury [NSSI], suicidal behaviors) than previously assumed. The aim of this study was to replicate findings of this prior research on adult populations in adolescents with a history of restrictive eating. A total of 117 adolescents between ages 12-14 were included in the study. Participants reported the presence and frequency of binge eating, compensatory, restrictive eating, and NSSI. Participants also reported thoughts of and intentions to hurt and kill themselves when engaging in each behavior on average. The t-tests and linear effects models were conducted to compare self-harming thoughts and intentions across behaviors. Participants reported at least some intent to hurt themselves physically in the moment and in the long-term when engaging in all ED behaviors and NSSI, and reported engaging in these behaviors while thinking about suicide. Direct self-harming knowledge and intentions were most frequently reported with NSSI and longer-term knowledge and intentions via NSSI and restrictive eating. Additionally, participants reported some suicidal thoughts and intentions across behaviors. This study replicates prior research, suggesting that adolescents engage in ED behaviors and NSSI with non-zero self-harming and suicidal thoughts and intentions. ED behaviors and NSSI may better be explained on a continuum. Implications include the recommendation of safety planning during ED treatment. This study highlights the overlap between eating disorder (ED) behaviors, nonsuicidal self-injury (NSSI), and suicide. Though clear distinctions typically exist for motives of self-harming behavior between ED behaviors (i.e., indirect, in the long run) and NSSI (i.e., direct, in the moment), this research suggests that intentions for self-harming and suicide may exist on a continuum. Clinical ED treatment should consider safety planning as part of routine interventions.