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Early adaptive schemas, emotional regulation, and cognitive flexibility in eating disorders: subtype specific predictors of eating disorder symptoms using hierarchical linear regression

Mitchell JS, Huckstepp T, Allen A, Louis PJ, Anijärv TE, Hermens DF

Eat Weight Disord, 2024 Aug 29;29(1):54.
PMID: 39210038 DOI: 10.1007/s40519-024-01682-4

PURPOSE: Understanding how early adaptive schemas, cognitive flexibility, and emotional regulation influence eating disorder (ED) symptoms, and whether this differs across diagnostic subtypes is critical to optimising treatment. The current study investigated the relationship between these variables and ED symptomology in individuals self-reporting an ED diagnosis and healthy controls.
METHODS: A dataset of 1576 online survey responses yielded subsamples for anorexia nervosa (n = 155), bulimia nervosa (n = 55), binge eating disorder (n = 33), other specified feeding or eating disorder (n = 93), and healthy participants (n = 505). The hierarchical linear regression analysis included Eating Disorder Examination Questionnaire 6.0 Global Score as the dependent variable; Young Positive Schema Questionnaire, Emotional Regulation Questionnaire, and Cognitive Flexibility Inventory subscale scores as the independent variables; and demographic measures as the covariates.
RESULTS: The number of significant predictors varied considerably by ED sub-group. Amongst the anorexia nervosa, bulimia nervosa, and healthy subsamples, the adaptive schema Self-Compassion and Realistic Expectations was associated with lower ED symptom severity. In comparison, age and body mass index were the strongest predictors for binge eating disorder, whilst the Expressive Suppression (a subscale of the Emotional Regulation Questionnaire) was the strongest predictor for other specified feeding or eating disorders.
CONCLUSION: Early adaptive schemas, cognitive flexibility, and emotional regulation vary across ED subtype, suggesting the need for tailored treatment that disrupts the self-reinforcing cycle of ED psychopathology. Future research investigating how early adaptive schemas may predict or be associated with treatment response across diagnostic subtypes is needed.
LEVEL OF EVIDENCE: Level IV, evidence obtained from multiple time-series with or without the intervention, such as case studies.

Matched MeSH terms: Bulimia Nervosa/diagnosis; Bulimia Nervosa/psychology
Fulltext Subclinical eating disorder, polycystic ovary syndrome- is there any connection between these two conditions through leptin- a twin study

Jahanfar Sh, Maleki H, Mosavi AR

Med J Malaysia, 2005 Oct;60(4):441-6.
PMID: 16570705

The genetic property of subclinical eating behaviour (SEB) and the link between SEB and polycystic ovary syndrome (PCOS) has been studied before but the role of leptin within this connection has never been investigated. The objective of this study was 1). to study the genetic property of SEB. 2). To find a link between leptin, SEB and PCOS. One hundred and fifty four (77 pairs) female-female Iranian twins including 96 MZ individuals (48 pairs) and 58 DZ individuals (29 pairs) participated in the study. Clinical, biochemical and ultrasound tools were used to diagnose polycystic ovary syndrome. BITE questionnaire was filled out for subjects. Eight percent of subjects were diagnosed for subclinical eating disorder. No significant difference was found between intraclass correlation of MZ and DZ (z = 0.57, P = 0.569). Serum leptin level correlated significantly with bulimia score (P < 0.007). The mean (+/-SD) value for bulimia score was found to be higher among PCOS(positive) subjects (3.27 +/- 5.51) in comparison with PCOS(negative) subjects (2.06 +/- 4.48) (P < 0.001). The genetic property of subclinical eating disorder was not confirmed as shared environment might have played a major role in likeliness of DZ twins as well as MZ. Leptin is linked with both subclinical eating disorder and PCOS.

Matched MeSH terms: Bulimia Nervosa/blood; Bulimia Nervosa/diagnosis; Bulimia Nervosa/genetics
Fulltext When disordered eating and disordered thinking happen together in a young person? a case report

Lai, M.H., Tan, Susan M.K.

ASEAN Journal of Psychiatry, 2014;15(1):101-105.
MyJurnal

Objective: This case report highlights the complexity of eating disorder in schizophrenia and outlines the diagnostic dilemma and challenges associated with the treatment. Methods: We report a 13 years old female with early onset schizophrenia who developed anorexic symptoms and binge eating. Her eating disturbances worsened after olanzapine was commenced. Results: A combination of pharmacological and psychosocial intervention led to remission of schizophrenia co-morbid with eating disorder NOS. Conclusion: Co-morbid diagnosis of schizophrenia and eating disorder is not uncommon. Early diagnosis and evidence-based intervention are imperative as untreated illness greatly impacts the developmental trajectory of young people. Meeting family’s needs improves family functioning which in turn improves patient’s outcome. ASEAN Journal of Psychiatry, Vol. 15 (1): January - June 2014: 101-105.

Matched MeSH terms: Bulimia Nervosa
Fulltext RELATIONSHIP BETWEEN BODY DISSATISFACTION ANDEATING DISORDER OF UNIVERSITY STUDENTS

TUAN NOR ATIQAH SYAFIQAH TUAN ABD AZIZ, MADIHAH SHUKRI

UMT Journal of Undergraduate Research, 2019;1(2):36-40.
MyJurnal

This study examined the relationship between body dissatisfaction and eating disorder of undergraduate students in University Malaysia Terengganu (UMT). Using stratified random sampling technique, data from 299 respondents was gathered. Body dissatisfaction was measured using Body Shape Questionnaire while eating disorders were assessed using Eating Attitudes Test. Descriptive statistics showed thatthe majority of the respondents reported no symptom of body dissatisfaction. With regard to eating disorders, respondents reported low levels of dieting, bulimia and oral control, indicating that an eating disorder in this sample was somewhat low. T-test analyses showed that there were no significant gender differences in body dissatisfaction as well as in eating disorders. However, there was evidence to suggest that female respondents had slightly higher level of eating disorder than males. Results of Pearsoncorrelations showed there was significant relationship between body dissatisfaction and total score of eating disorders, dieting, bulimia and oral control subtypes (r = .58, p

Matched MeSH terms: Bulimia Nervosa
Fulltext Factorial analysis of the eating attitude test (EAT-40) among a group of Malaysian university students

Talwar, P.

Malaysian Journal of Psychiatry, 2011;20(2):58-67.
MyJurnal

Eating disorders are a group of mental health concerns characterized by disturbance in eating behaviour that include, anorexia, bulimia, binge eating disorder, and other types of disordered eating. Adolescents are becoming increasingly vulnerable to eating disorders. The Eating Disorder Attitude Test (EAT-40) is a widely used screening instrument for detecting eating disorders. Several authors have translated the EAT-40 in various languages and validated the scale. The objective of the study included determining the factor structure of EAT-40 and to find the reliability. Method: 217 undergraduate university students in Malaysia were administered the EAT-40. In addition, they were also administered the Rosenberg’s Self Esteem scale to study the correlates of EAT-40. Results: The mean age of students was 22 years. The factor analysis of EAT-40 revealed a 34 item EAT model, with four subscales, ‘Dieting Behaviour’, ‘Oral Control’, ‘Food Preoccupation’ and ‘Body Image’. The short form is composed of 34 items and shows good internal consistency = 0.799.
Conclusion: It may be established that the EAT-34 shows an unidimensional structure with good internal consistency even though some items needs to be revised.

Matched MeSH terms: Bulimia Nervosa
Fulltext Bio-psychological perspectives of eating disorders and obesity: a revisited

Ainsah Omar, Osman Che Bakar

ASEAN Journal of Psychiatry, 2008;9(1):33-41.
MyJurnal

Food is closely related with emotion. It often provides comfort and satisfaction. Some individuals choose to turn to food to curb their negative emotion, resulting in disturbances in
eating patterns, such as overeating which lead to obesity and severely controlling food intake, which culminate in eating disorders like anorexia nervosa, bulimia nervosa and binge eating. These disorders are not related to the eating problems per se but often due to underlying or complicated by psychological factors, namely depression, anxiety, impulse control problems and personality. The roles of psychological factors in eating disorders and obesity should therefore not be downplayed. These disorders should be managed comprehensively involving multiple approaches, including not only biological but also psychological interventions provided by a professional team comprising endocrinologists, psychiatrists, dietitians, exercise physicians and surgeons.

Matched MeSH terms: Bulimia Nervosa