Eating Disorder Examination Questionnaire Subscales Research Articles

Weight gain and eating disorder symptoms among individuals with atypical anorexia nervosa.

The purpose of this study was to examine the association between weight gain and eating disorder (ED) symptoms among adults receiving treatment for atypical anorexia nervosa (AAN), to determine whether those who had a higher percent of expected body weight (%EBW) at discharge exhibited lower ED symptoms than those who gained less weight, and to compare this group to a matched sample of patients with anorexia nervosa (AN). Participants were 96 adults receiving treatment at an ED treatment facility between December 2020 and May 2023. The Eating Disorder Examination-Questionnaire (EDE-Q) was completed at admission and discharge, and %EBW was obtained at admission and discharge. All EDE-Q subscale scores improved from admission to discharge for patients with AAN and patients with AN. Neither %EBW at discharge nor weight gain were associated with EDE-Q subscale scores for those with AAN. For patients with AN, %EBW at discharge and weight gain were associated with EDE-Q Restraint at discharge. Weight restoring to a higher level and gaining more weight were not associated with EDE-Q scores at discharge for AAN. Further research is needed to determine how weight restoration using intensive treatment settings affects remission and recovery in patients with AAN.

A SURVEY ON SPORTS ACTIVITY INVOLVEMENT, MENSTRUAL HISTORY AND EATING DISORDERS IN MALAYSIAN ELITE FEMALE ATHLETES

This study investigated sports activity involvement, menstrual history, and prevalence of eating disorders among Malaysian elite female athletes. A total of 50 female national and state level athletes with a mean age of 21.16 ± 2.31 years old participated in this study. They were 6 gymnasts, 17 swimmers, 5 cyclists, 7 long distance runners, and 15 silat athletes. The participants were required to answer the sports activity involvement questionnaire, menstrual history questionnaire, and Eating Disorder Examination Questionnaire (EDE-Q). The present study found that 44 (88%) of the total participants had regular menstruation, while 6 (12%) participants had irregular menstruation. The global score of EDE-Q subscales was 1.71 (60 to 65 percentile rank) in all the participants. Comparisons of measured variables between participants with regular menstruation and irregular menstruation showed that age in years at the beginning of training was younger in participants with irregular menstruation (9.83 ± 4.07) than participants with regular menstruation (11.84 ± 3.52). The global score of EDE-Q subscales was higher in participants with irregular menstruation (2.32; 75 to 80 percentile rank) than participants with regular menstruation (1.63; 60 to 65 percentile rank). In conclusion, the results of the present study show that participants with irregular menstruation seem to have higher global score of EDE-Q subscales, i.e., restrain, eating concern, shape concern, and weight concern. Irregular menstruation may be related to the young starting age of the athletes involved in training and the long total training period in years.

Psychometric properties of the Parent Eating Disorder Examination Questionnaire.

To examine the psychometric properties of the Parent Eating Disorder Examination Questionnaire (PEDE-Q), developed to improve eating disorder (ED) assessment among youth by including parents as informants. A multi-site, transdiagnostic sample of 355 adolescents with EDs completed the Eating Disorder Examination Questionnaire (EDE-Q) and their parents completed the PEDE-Q. The internal consistencies of the PEDE-Q subscales were on par with established EDE-Q ranges (.73 to .90), both when examined using the original four-factor EDE-Q subscales and the seven-item, three-factor subscales of the brief EDE-Q. Statistically significant medium- to large-sized correlations and poor to moderate levels of agreement were found between the corresponding EDE-Q and PEDE-Q subscales. Receiver-operator characteristic (ROC) curves showed that the PEDE-Q had a statistically significant area under the curve (AUC) to maximize sensitivity and specificity in diagnosing full-syndrome AN, whereas the EDE-Q did not. Based on chi-square analyses, the PEDE-Q identified a statistically significantly greater number of AN cases than the EDE-Q. The EDE-Q yielded a BN diagnosis more frequently than the PEDE-Q, although this difference was not statistically significant. Results suggest that the PEDE-Q has good psychometric properties and provides incremental information that can aid in the assessment and diagnosis of adolescents with EDs, particularly those with AN. There exist complex challenges to identifying clinically significant eating disorders among youth. The PEDE-Q is a questionnaire measure that improves eating disorder assessment among children and adolescents by asking parents to report on the symptoms and behaviors they have observed in their child and that youth may not fully disclose. The PEDE-Q can aid in the diagnosis of adolescents with eating disorders, particularly those with anorexia nervosa.

Examination of the Reliability and Validity of the Minnesota Multiphasic Personality Inventory-3 (MMPI-3) in a Preoperative Bariatric Surgery Sample.

Presurgical psychological assessment of bariatric surgery candidates aims to identify psychosocial risk factors and provide treatment recommendations to facilitate optimal outcomes. Such assessment typically includes psychometric testing and a clinical interview. The Minnesota Multiphasic Personality Inventory (MMPI) has been commonly used as a broadband measure to assess a number of psychosocial domains in bariatric clinics. The newest version of the MMPI, the MMPI-3, was recently released. This study sought to (1) establish whether the MMPI-3 is comparable to the MMPI-2-RF in a sample of patients seeking bariatric surgery, (2) report reliability data for all MMPI-3 scale scores in this sample, and (3) explore associations between commonly used self-report symptom measures and substantive scales of the MMPI-3 to ascertain convergent and discriminant validity patterns. Six hundred and thirty-five presurgical patients completed the MMPI-3 in addition to the Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7), Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), and Eating Disorder Examination-Questionnaire (EDE-Q). The majority (79.1%) of the sample was female, 65.5% was white, and 26.6% was Black. Scores on most of the MMPI-3 Emotional/Internalizing Dysfunction scales were meaningfully associated with the PHQ-9, GAD-7, and most EDE-Q subscales (except for Restraint). Meaningful discriminant patterns were observed as well. We conclude that the substantive scales of the MMPI-3 are reliable, comparable to their MMPI-2-RF counterparts, and evidence good convergent validity with extra-test measures assessing depression, anxiety, alcohol use, and eating disorder psychopathology in a preoperative bariatric sample.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10880-022-09908-2.

Eating Disorder Symptoms as a Risk Factor for Hypoactive Sexual Desire Disorder in Women: A Pilot-study

ABSTRACT Introduction Eating and sexual behavior are driven by neurological mechanisms that are extremely intertwined; emerging evidence indicates that their deep relationship can be mediated by the presence of specific psychopathologies. Objective To investigate the relationship between female sexual dysfunction (FSD) and eating disorders (EDs). Methods 123 retrospectively recruited women consulting for FSD underwent physical examination and completed the following validated questionnaires: Female Sexual Function Index (FSFI), Female Sexual Distress Scale-Revised (FSDS-R), Eating Disorder Examination Questionnaire (EDE-Q), Binge Eating Scale (BES), Emotional Eating Scale (EES), Barrat Impulsiveness Scale-11 (BIS-11), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory Y (STAI Y), Symptom Checklist 90-Revised (SCL-90-R), Body Uneasiness Test (BUT), Dyadic Adjustment Scale (DAS) and Sexual Inhibition/Sexual Excitation Scales (SIS/SES). Moreover, demographic, medical and psycho-sexuological data were obtained through a structured interview. Results In relation to menopausal status, we did not observe any significant difference in all the investigated questionnaires in pre- vs. postmenopausal women. When stratifying patients for BMI (<25, 25-30, >30 kg/m2) we found that all the scores related to EDE-Q subscales were significantly different among the three subgroups (all p<0.001). Furthermore, patients with a history of Unwanted Sexual Experience (USE) had significantly higher BES (p=0.034) and EES (p=0.027) total scores compared with those without. Moreover, when we stratified our patients according to the clinical diagnosis of Hypoactive Sexual Desire Disorder (HSDD), we found that those with HSDD showed a worst psychological profile than those without, in particular a higher score at EDE-Q and BDI (all p<0.05). In contrast, when stratifying patients for the other two main FSD diagnosis, Female Genital Arousal Disorder (FGAD) and Female Orgasm Disorder (FOD), no significant differences among all the investigated questionnaires were observed. To further verify the impact of the different psychopathological aspects on the risk of having HSDD, we found that the only questionnaires scores that contributed to this dysfunction were EDE-Q (OR 1.678, IC [1.164-2.421]; p=0.006), total BDI (OR 1.055, IC [1.006-1.107]; p=0.027) and SIS1 (OR 1.101, IC [1.109-1.190]; p=0.015), after adjustment for age. After simultaneous analysis in a multivariate model of the three questionnaires, we found that both a higher EDE-Q score and a higher SIS1 score were significant risk factors for HSDD (p=0.007 and p=0.034, respectively). Finally, we subdivided our patients into three groups: no Binge Eating (BE), sporadic BE and frequent BE, observing a significant positive association between frequency of BE and sexual distress, as assessed by FSDS-R total score. Conclusions In a population of women affected by FSD, ED traits could negatively affect sexual desire, representing a relevant risk factor for the clinical diagnosis of HSDD. Among all the investigated psychopathological aspects, the psychological alterations related to EDs seem to play a more pronounced effect on HSDD than other commonly accepted risk factors for sexual desire disorders, such as depression and increased inhibitory trait. In a clinical perspective, it would worth to investigate the relative change in FSD and ED after treatment for ED and vice versa. Disclosure No

Eating disorder symptoms as a risk factor for hypoactive sexual desire disorder in women: A pilot-study

ABSTRACT Introduction Eating and sexual behavior are driven by neurological mechanisms that are extremely intertwined; emerging evidence indicates that their deep relationship can be mediated by the presence of specific psychopathologies. Objective to investigate the relationship between female sexual dysfunction (FSD) and eating disorders (EDs). Methods 123 retrospectively recruited women consulting for FSD underwent physical examination and completed the following validated questionnaires: Female Sexual Function Index (FSFI), Female Sexual Distress Scale-Revised (FSDS-R), Eating Disorder Examination Questionnaire (EDE-Q), Binge Eating Scale (BES), Emotional Eating Scale (EES), Barrat Impulsiveness Scale-11 (BIS-11), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory Y (STAI Y), Symptom Checklist 90-Revised (SCL-90-R), Body Uneasiness Test (BUT), Dyadic Adjustment Scale (DAS) and Sexual Inhibition/Sexual Excitation Scales (SIS/SES). Moreover, demographic, medical and psycho-sexuological data were obtained through a structured interview. Results in relation to menopausal status, we did not observe any significant difference in all the investigated questionnaires in pre- vs. post-menopausal women. When stratifying patients for BMI (<25, 25-30, >30 kg/m2) we found that all the scores related to EDE-Q subscales were significantly different among the three subgroups (all p<0.001). Furthermore, patients with a history of Unwanted Sexual Experience (USE) had significantly higher BES (p=0.034) and EES (p=0.027) total scores compared with those without. Moreover, when we stratified our patients according to the clinical diagnosis of Hypoactive Sexual Desire Disorder (HSDD), we found that those with HSDD showed a worst psychological profile than those without, in particular a higher score at EDE-Q and BDI (all p<0.05). In contrast, when stratifying patients for the other two main FSD diagnosis, Female Genital Arousal Disorder (FGAD) and Female Orgasm Disorder (FOD), no significant differences among all the investigated questionnaires were observed. To further verify the impact of the different psychopathological aspects on the risk of having HSDD, we found that the only questionnaires scores that contributed to this dysfunction were EDE-Q (OR 1.678, IC [1.164-2.421]; p=0.006), total BDI (OR 1.055, IC [1.006-1.107]; p=0.027) and SIS1 (OR 1.101, IC [1.109-1.190]; p=0.015), after adjustment for age (Fig. 1). After simultaneous analysis in a multivariate model of the three questionnaires, we found that both a higher EDE-Q score and a higher SIS1 score were significant risk factors for HSDD (p=0.007 and p=0.034, respectively). Finally, we subdivided our patients into three groups: no Binge Eating (BE), sporadic BE and frequent BE, observing a significant positive association between frequency of BE and sexual distress, as assessed by FSDS-R total score (Fig. 2). Conclusions in a population of women affected by FSD, ED traits could negatively affect sexual desire, representing a relevant risk factor for the clinical diagnosis of HSDD. Among all the investigated psychopathological aspects, the psychological alterations related to EDs seem to play a more pronounced effect on HSDD than other commonly accepted risk factors for sexual desire disorders, such as depression and increased inhibitory trait. In a clinical perspective, it would worth to investigate the relative change in FSD and ED after treatment for ED and vice versa. Disclosure Work supported by industry: no.

Feasibility of guided internet-based cognitive behavioral therapy for patients with anorexia nervosa

ObjectiveThe objective of the present study was to investigate the feasibility of guided internet cognitive behavioral therapy (ICBT) for anorexia nervosa. MethodsWe conducted a prospective single-arm study between January 2020 and March 2021. The intervention was built using videos, web programs, and chat tools. The intervention program was largely based on metacognitive training. Participants performed the self-help program once a week for 12 consecutive weeks. The primary outcome was the global Eating Disorder Examination Questionnaire (EDE-Q) score. Secondary outcomes included clinical symptoms of eating disorders, metacognitive function, body mass index, depression, and generalized anxiety. The main statistical analysis examined whether the EDE-Q score and other outcomes at the end of the intervention differed from the baseline. ResultsFourteen participants underwent the trial treatment, and 13 completed the intervention. There was a significant reduction in the global EDE-Q score from 3.48 (SD = 1.4) to 2.54 (SD = 1.5, p = 0.02, Cohen's d = 0.75) from baseline to post-intervention. Some EDE-Q subscales and body checking questionnaire scale demonstrated statistically significant improvements, with moderate to large effect sizes. Although there was no significant improvement in body mass index, metacognitive function, or depressive symptoms, there was a significant improvement in the severity of generalized anxiety (M = −4.0, p = 0.01, Cohen's d = 0.95). No adverse events were observed. DiscussionOur findings suggest that guided ICBT for anorexia nervosa is well accepted by female patients and practical as a telemedicine approach that improves symptoms. In the future, tightly controlled randomized controlled trials should be conducted for efficacy verification.

Effectiveness of internet-based cognitive behavioural therapy for binge eating disorder

IntroductionBinge eating disorder (BED) is the most prevalent specific eating disorder. It is characterized by recurrent episodes of binge eating and is associated with feelings of shame and a lack of control. Internet-based treatments are gaining increasing attention as a way to reach more patients with evidence based treatments In 2020 we conducted a preliminary analysis on the effectiveness of an internet-based cognitive behavioural therapy treatment project (Jensen ES, Linnet, J, Holmberg TT, Tarp K, Nielsen JH, Lichtenstein MB. Effectiveness of internet-based guided self-help for binge-eating disorder and characteristics of completers versus noncompleters. Int J Eat Disord. 2020;1-6. https://doi.org/10.1002/eat.23384).ObjectivesThis study aims to update the analyses on treatment effect with the patients who have completed treatment in the year following the last data extraction.MethodsThe iBED treatment project is a 10-session psychologist guided internet-based self-help program based on cognitive behavioural therapy. When applying for treatment and upon completion patients respond to a survey containing, among other scales, the eating disorder examination-questionnaire (EDE-Q), binge eating disorder-questionnaire (BED-Q) and various sociodemographic questions. Data will be extracted from the treatment project in anonymized form for analyses.ResultsThe preliminary analyses were conducted on 36 completers. These showed large standardized effect sizes on both the EDE-Q subscales (Cohens d ranging from .88-1.65) and on the BED-Q (d = 1.38). The updated effectiveness analyses will be presented at the conference. We expect approximately 70-80 patients to have completed treatment at this time.ConclusionsResults will be discussed and presented at the conference.

The effect of cognitive symptoms in binge eating disorder on depression and self-esteem: a cross-sectional study.

To compare individuals with class II and III obesity with and without binge eating disorder (BED) in terms of sociodemographic characteristics, depressive symptoms, self-esteem, eating behaviors, and cognitive variables thought to be involved in the pathophysiology of the disease. The participants were selected from volunteer patients with body mass index ≥ 35 applying to the Ondokuz Mayıs University Medical Faculty, Turkey, for bariatric surgery between 01.07.2016 and 31.05.2019. The Beck Depression Inventory (BDI), Rosenberg Self-Esteem Scale (RSES), and Eating Disorder Examination Questionnaire (EDE-Q) were administered to all participants. Binge eating disorder (BED) was determined in 95 (34%) of the 278 individuals applying for bariatric surgery. The frequency of previous psychiatric diseases was higher in the BED group than in the non-BED group. BDI, RSES, total EDE-Q, weight concern, shape concern, and eating concern EDE-Q subscale scores were also higher in the BED group. Correlation analysis revealed positive low correlation between depression scores and total EDE-Q scores and all subscales scores, with the exception of restraint. Positive low correlation was determined between decreased self-esteem and body weight and shape concern. At multivariate regression analysis, cognitive variables explained 28.6% of variance in depressive symptoms in the BED group, and 21.5% of variance in self-esteem. The study results showed elevation in cognitive factors in patients with BED compared to the controls. Among these variables, eating and weight concern were shown to be associated with depressive symptoms, while eating concern was linked to self-esteem. Level III, case-control analytic study.

Eating-disordered behavior among male and female college students in Iran

ObjectiveFew studies of eating-disorder behaviors (EDBs) in Iran have been conducted and no study has examined the occurrence of these behaviors (EDBs) among young Iranian men. This cross-sectional study examined the occurrence of EDBs, as assessed by the Eating Disorder Examination Questionnaire (EDE-Q), among young men and women in Iran. MethodMale (n = 253) and female (n = 384) college students completed the EDE-Q. Mean scores on the EDE-Q subscales and the occurrence and regular occurrence of EDBs, namely, binge eating, self-induced vomiting, laxative misuse, extreme dietary restriction and excessive exercise, were compared between male and female participants. ResultsFemale students had higher scores on the EDE-Q Shape Concern subscale than males, whereas scores on the other subscales did not differ by gender. Male students were more likely to report self-induced vomiting (any occurrence: 10.4% vs. 3.2%) and excessive exercise (28.0% vs. 20.0%) than female students. The occurrence of other EDBs did not differ by gender and binge eating was the most common EDB in both men (regular occurrence = 24.7%) and women (27.5%). ConclusionThe findings suggest that EDBs are relatively common among college students in Iran and that most EDBs are equally common among male and female students. Prevention and health promotion programs designed to reduce the occurrence and adverse impact of EDBs may be increasingly important in Iran.

Exercise Obsession and Compulsion in Adults With Longstanding Eating Disorders: Validation of the Norwegian Version of the Compulsive Exercise Test.

ObjectivesThe objectives of this study were to (1) validate the Norwegian version of the Compulsive Exercise Test (CET) in adults with longstanding eating disorders, and (2) explore predictors of high CET-score.Methods:Adult inpatients (n = 166) with longstanding DSM-IV Anorexia Nervosa, Bulimia Nervosa (BN) or Eating Disorder not Otherwise Specified (EDNOS) completed the CET instrument, Eating Disorder examination questionnaire (EDE-Q), Beck Depression Inventory-II (BDI-II) and Symptom checklist-90 (SCL-90). A total CET score of 15 or above was defined as high CET-score. ANOVA, Confirmatory factor analysis, Pearson’s correlation, and logistic regression were used to analyze the data.ResultsCronbach’s alpha varied from 0.68 to 0.96 for the CET and its subscales. The confirmatory factor analysis showed adequate fit. Convergent validity of the CET demonstrated correlation between EDE-Q global and subscale scores and CET total score. The same pattern was found for correlation between CET subscales and EDE-Q subscales. EDE-Q global score and frequency of exercise episodes predicted high CET-score, yet 21% of the patients with high CET score had less than one episode of exercise per week.ConclusionThe Norwegian version of CET is valid and useful for assessing compulsive exercise in a sample with longstanding ED. The understanding of compulsive exercise must to a greater extent differ between obsessions and compulsions, as a significant number of patients with high CET score showed no or little exercise behavior.

Culture Change and Eating Patterns: A Study of Georgian Women.

Introduction: Immigration and culture change have been thought to affect various aspects of psychological well-being, including eating behaviors. This study aimed to examine the association between immigration, acculturation strategies and eating patterns. Materials and Methods: Acculturation was conceptualized and measured by acculturation strategies of integration (maintaining original culture and adopting the new culture), assimilation (adopting the new culture and leaving behind the old), separation (sticking with the original culture only) and marginalization (maintaining/adopting neither culture). Eating patterns were conceptualized by dietary restriction, eating concern, shape concern, and weight concern. Links between demographic variables, acculturation strategies, and eating patterns were also examined. Five hundred and six Georgian women took part in the study: 253 living abroad (UK and USA) and 253 living in Georgia. Measures included East Asian Acculturation Measure (EAAM) for acculturation strategies (assimilation, integration, separation, and marginalization subscales) and Eating Disorder Examination Questionnaire (EDEQ) for eating patterns (dietary restriction, eating concern, weight concern, shape concern subscales, and global score). Relevant demographic variables and Body Mass Index (BMI) were recorded. Results: Comparisons of immigrant and nonimmigrant groups using Multivariate Analysis of Covariance (MANCOVA) with BMI as a covariate found a difference in dietary restriction only, with immigrants yielding higher mean score than non-immigrants. The global EDEQ scores of immigrant and nonimmigrant groups were almost identical though. Correlations between separation and marginalization and four EDEQ scores were statistically significant and positive, while correlations between integration and two EDEQ subscales were marginally significant and negative. Regression analysis showed that separation and marginalization strategies of acculturation were significantly linked with EDEQ eating concern, shape concern, weight concern, and global scores thereby representing predictors of elevated eating outcomes. Discussion: Findings suggested that moving to Western countries increased dietary restriction among Georgian women. Furthermore, while living abroad, the lack of integration in a host culture, as a common denominator of separation and marginalization strategies of acculturation, may predict elevated eating, shape, and weight concerns among women relocated over six years ago. Acculturation conditions may also be linked with integration or well-being outcomes.

Evaluation of the reliability and validity of the Italian version of the schema mode inventory for eating disorders: short form for adults with dysfunctional eating behaviors.

To examine the psychometric properties and the factorial structure of the Italian version of the schema mode inventory for eating disorders-short form (SMI-ED-SF) for adults with dysfunctional eating patterns. 649 participants (72.1% females) completed the 64-item Italian version of the SMI-ED-SF and the eating disorder examination questionnaire (EDE-Q) for measuring eating disorder symptoms. Psychometric testing included confirmatory factor analysis (CFA) and internal consistency. Multivariate analysis of covariance (MANCOVA) was also run to test statistical differences between the EDE-Q subscales on the SMI-ED-SF modes, while controlling for possible confounding variables. Factorial analysis confirmed the 16-factors structure for the SMI-ED-SF [S-Bχ2 (1832) = 3324.799; p < .001; RMSEA = 0.045; 90% CI 0.043-0.048; CFI = 0.880; SRMR = 0.066; χ2/df = 1.81; < 3]. Internal consistency was acceptable in all scales, with Cronbach's Alpha coefficients ranging from 0.635 to 0.873. The SMI-ED-SF represents a reliable and valid alternative to the long-form SMI-ED for assessment and conceptualization of schema modes in Italian adults with disordered eating habits. Its use is recommended for clinical and research purposes. Level V, descriptive study.

Disordered Eating Among a Diverse Sample of First-Year College Students

Objective: A cross-sectional study of first-year college students was conducted to identify the prevalence and predictors of disordered eating (DE).Methods: College freshmen students, aged 18 years, (n = 106) completed the Eating Disorder Examination Questionnaire (EDE-Q) and a supplemental survey. A subset of the sample (n = 77) underwent measurements of height, weight, and body composition. DE was defined as an elevated (3) weight, shape, eating concern, or dietary restraint EDE-Q subscale score.Results: The sample, consisting of 56.6%, 15.1%, 11.3%, and 11.3% Latino/a, Asian, African American, and Caucasian students, respectively (37% male), reported a 31.1% prevalence of DE. The current desire to lose weight was the strongest predictor of DE (odds ratio = 15.3; 95% confidence interval = 2.8, 82.5). Other variables linked to DE or elevated EDE-Q subscale scores included body mass index (BMI) 25.0 kg/m2, vegetarianism, weight loss in the past year, female gender, and eating breakfast < 5 d/wk. Participants with BMI 25.0 kg/m2 and the current desire to lose weight (n = 23) or following a vegetarian diet (n = 5) exhibited the highest prevalence of DE (78.3% and 80.0%, respectively). A higher proportion of Latinas reported binge episodes compared to female Caucasian, Asian, and African American students (36.4% vs. 0.0%, 6.7%, and 28.6%, respectively, p = 0.056, χ2 = 7.6). Males, versus females, were more likely to report excessive exercise (56.4% vs. 37.3%, p = 0.056, χ2 = 3.6).Conclusions: This study adds to the current body of literature on DE by providing a diverse sample and potentially novel predictors and risk factors for DE.

Self-Concept and Disturbed Eating Behavior in a Clinical Population of Adolescents with Eating Disorders

Introduction: Changes in self-concept have been considered to play a crucial role in the etiology of eating disorders. In this study, we evaluate the levels of self-concept and severity of the disturbed eating behavior in a clinical population of adolescents with Eating Disorders (ED) and study their correlations. Method: A sample of 50 patients of an Adolescent Psychiatric Service completed two validated self-report scales: the Piers- Harris Children’s Self-concept Scale (PHCSCS) and the Eating Disorder Examination - Questionnaire (EDE-Q). Anthropometric data were also collected. Results:Total self-concept had a negative correlation with disease severity [total EDE-Q (rs= -0.48)], as well as with four subscales of the EDE-Q [Dietary Restraint (rs =-0.30); Weight Concern (rs=-0.44); Shape Concern (rs=-0.56); and Eating Concern (rs=-0.40)]. Four of the PHCSCS subscales showed a negative correlation with the severity of the disease [Behavioral Adjustment (rs=-0.39); Freedom from Anxiety (rs=-0.56); Popularity (PO) (rs=-0.43) and Happiness and Satisfactions (HS) (rs=-0.39)]. Then the sample was divided into two groups: Compulsive / Purgative [5 Bulimia Nervosa (BN) + 3 Unspecified Feeding and Eating Disorder (UFED) with insufficient criteria for BN] and Restrictive (38 Anorexia Nervosa + 4 UFED with insufficient criteria for AN). The Compulsive / Purgative group had lower Self-concept than the Restrictive group (p <0.05). This first group also presented lower values than the Restrictive group in all subscales of the PHCSCS, but with statistical significance only in the Intellectual and School Status and HS. It also presented higher disease severity (p <0.05), with higher values in all four EDE-Q subscales, but with statistical significance only in Weight Concern (p <0.05).Conclusions: These results are in agreement with the literature that the Self-concept is altered in ED. In our study, we report an inverse correlation between self-concept and dysfunctional eating behaviors. The Compulsive/Purgative group reported a lower self-concept and greater severity of the eating behavior pathology, but there were no clinical differences between the two groups. This finding may be explained by the lower morbidity awareness of the Restrictive group.

Starvation symptoms in patients with anorexia nervosa: a longitudinal study

ABSTRACTObjective. The aim of this study was to evaluate the change in starvation symptoms over time and their role as potential predictors of change in eating disorder and general psychopathology in patients with anorexia nervosa treated by means of intensive enhanced cognitive behavioral therapy (ICBT-E).Method. Ninety adult female patients with anorexia nervosa (63 restricting type and 27 binge-eating/purging type) were recruited. Body mass index (BMI), Eating Disorder Examination (EDE) interview, Eating Disorder Examination Questionnaire (EDE-Q), Brief Symptom Inventory (BSI) and Starvation Symptoms Inventory (SSI) scores were recorded at admission, at the end of treatment, and at 6-month follow-up. All tests, except for the EDE, were also administered after 4 weeks of treatment to assess the role of refeeding on these variables.Results. At baseline, starvation symptoms were correlated with measures of eating disorder and general psychopathology. The treatment was associated with a significant increase in BMI, improvement in eating disorder and general psychopathology, and a significant reduction in starvation symptoms. The change in SSI scores from baseline to 4 weeks predicted the improvement in EDE eating concern subscale and global BSI scores. Among patients who had restored their body weight by the end of treatment, dietary restraint and eating concern EDE-Q subscales, global EDE-Q and SSI scores showed greater improvement in the first 4 weeks than in the remaining 16 weeks of treatment.Discussion. The findings underline the close relationship between improvements in both starvation symptoms and eating disorder and general psychopathology and indicate the important role of refeeding in ameliorating both.

Factorial Structure and Preliminary Validation of the Schema Mode Inventory for Eating Disorders (SMI-ED).

Objective: The aim of this study was to examine the psychometric properties and factorial structure of the Schema Mode Inventory for Eating Disorders (SMI-ED) in a disordered eating population.Method: 573 participants with disordered eating patterns as measured by the Eating Disorder Examination Questionnaire (EDE-Q) completed the 190-item adapted version of the Schema Mode Inventory (SMI). The new SMI-ED was developed by clinicians/researchers specializing in the treatment of eating disorders, through combining items from the original SMI with a set of additional questions specifically representative of the eating disorder population. Psychometric testing included Confirmatory Factor Analysis (CFA) and internal consistency (Cronbach's α). Multivariate Analyses of Covariance (MANCOVA) was also run to test statistical differences between the EDE-Q subscales on the SMI-ED modes, while controlling for possible confounding variables.Results: Factorial analysis confirmed an acceptable 16-related-factors solution for the SMI-ED, thus providing preliminary evidence for the adequate validity of the new measure based on internal structure. Concurrent validity was also established through moderate to high correlations on the modes most relevant to eating disorders with EDE-Q subscales. This study represents the first step in creating a psychometrically sound instrument for measuring schema modes in eating disorders, and provides greater insight into the relevant schema modes within this population.Conclusion: This research represents an important preliminary step toward understanding and labeling the schema mode model for this clinical group. Findings from the psychometric evaluation of SMI-ED suggest that this is a useful tool which may further assist in the measurement and conceptualization of schema modes in this population.

Eating psychopathology and psychosocial impairment in patients treated at a Singapore eating disorders treatment programme.

There is limited data on the psychopathology of eating disorders in Singapore. This study: (a) described levels of eating psychopathology and psychosocial impairment among individuals diagnosed with eating disorders at our hospital; and (b) compared the related psychopathology of these patients. Between 1 August 2010 and 31 July 2012, 257 individuals who met the diagnostic criteria for eating disorders completed the Eating Disorder Examination Questionnaire (EDE-Q) and Clinical Impairment Assessment questionnaire (CIA). A majority of participants were women and of Chinese ethnicity. Diagnoses included anorexia nervosa (AN; 41.6%), bulimia nervosa (BN; 29.6%) and eating disorder not otherwise specified (EDNOS; 28.8%). Mean age at presentation was 20.52 ± 7.14 years and mean body mass index was 17.84 ± 4.18 kg/m2. Individuals with AN were significantly younger at presentation and had shorter duration of untreated illness compared to those with BN and EDNOS. There were no significant differences in the CIA scores of the diagnostic groups. Participants with BN scored higher in all subscales of the EDE-Q than those with AN and EDNOS. Our sample scored lower in most subscales of EDE-Q when compared to treatment centres in Sweden, Australia and the United States. Our clinical sample reported lower scores of psychopathology compared to overseas centres. This could be attributed to the higher percentages of BN and EDNOS diagnosed in overseas populations. Individuals with AN showed higher levels of psychopathology in our study compared to patients from the United States.

The Anorexia Nervosa Stages of Change Questionnaire and the Bulimia Nervosa Stages of Change Questionnaire: their psychometric properties in a Turkish sample

Objective: Deficits in motivation to change are common among individuals with eating disorders, yet there has been an absence of research on motivation in non-Western countries. The aim of this study was to develop mea-sures of motivation to change based on the Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ) and the Bulimia Nervosa Stages of Change Questionnaire (BNSOCQ) in a Turkish population. Methods: Forty-four women with anorexia nervosa and thirty-one women with bulimia nervosa participated in the study. In order to show the reliability of the ANSOCQ and BNSOCQ, Cronbach’s alpha values were evaluated. Pearson Correlation Coeffi-cient test was used to analyze correlations between the ANSOCQ/BNSOCQ and both the Eating Disorder Examination Questionnaire (EDEQ) and Beck Depression Inventory (BDI). The Student’s t-test for independent samples was used to compare mean total scores on the ANSOCQ and BNSOCQ across the current phase of illness groups. Results: The Turkish versions of the ANSOCQ and BNSOCQ demonstrated good internal consistency (Cronbach’s alpha=0.92 and 0.89, respectively). In terms of convergent validity, negative correlations were found between the ANSOCQ/BNSOCQ and each of the EDEQ subscales and (for the ANSOCQ alone) the BDI. Also, participants in the active phase of illness reported a significantly lower level of motivation compared to those in remission. Discus-sion: The study provides initial support for the reliability and validity of the ANSOCQ and BNSOCQ in a Turkish sample, which will enable greater cross-cultural research on motivation in eating disorders.

Eating Disorder Examination Questionnaire (EDE-Q) and Clinical Impairment Assessment (CIA): clinical norms and functional impairment in male and female adults with eating disorders

Aim: The aim of the current study was to collect clinical normative data for the Clinical Impairment Assessment questionnaire (CIA) and the Eating Disorder Examination Questionnaire (EDE-Q) from adult patients with eating disorders (EDs). This study also examined unique contributions of eating disorder (ED) symptoms on levels of ED-related impairment.Methods: A sample of 667 patients, 620 females and 47 males, was recruited from six specialist centres across Norway. The majority of the sample (40.3%) was diagnosed with eating disorder not otherwise specified (EDNOS), 34.5% had bulimia nervosa (BN), and 25.2% were diagnosed with anorexia nervosa (AN).Results: There were significant differences for global EDE-Q and CIA scores between females and males. In the female sample, significant differences were found on several EDE-Q sub-scales between the AN and BN group, and between the AN and EDNOS group. No significant differences were found between the diagnostic groups on the CIA. In the male sample, no significant differences were found between diagnostic groups on the EDE-Q or CIA. A multiple regression analysis revealed that 46.8% of the variance in impairment as measured by the CIA was accounted for by ED symptoms.Conclusions: Body mass index, Eating Concern, Shape/Weight Concern, and binge eating served as significant, unique predictors of impairment. The results from the present study contribute to the interpretation of EDE-Q and CIA scores in ED samples.