The current clinical approach to feeding and eating disorders aimed to increase personalization of management

World Psychiatry, Год журнала: 2025, Номер 24(1), С. 4 - 31

Опубликована: Янв. 15, 2025

Feeding and eating disorders (FEDs) are a heterogeneous grouping of at the mind-body interface, with typical onset from childhood into emerging adulthood. They occur along spectrum disordered compensatory weight management behaviors, low to high body weight. Psychiatric comorbidities norm. In contrast other major psychiatric disorders, first-line treatments for FEDs mainly psychological and/or nutrition-focused, medications playing minor adjunctive role. Patients, carers clinicians all have identified personalization treatment as priority. Yet, FEDs, evidence base supporting this is limited. Importantly, related behaviors can serious physical consequences may put patient's life risk. these cases, immediate safety risk considerations least period need be prioritized over efforts care. This paper systematically reviews several key domains that relevant characterization individual patient FED aimed management. These include symptom profile, clinical subtypes, severity, staging, complications consequences, antecedent concomitant conditions, social functioning quality life, neurocognition, cognition emotion, dysfunctional cognitive schemata, personality traits, family history, early environmental exposures, recent stigma, protective factors. Where possible, validated assessment measures use in practice identified. The limitations current pointed out, possible directions future research highlighted. also novel approaches providing more fine-grained sophisticated ways personalize such those utilize neurobiological markers. We additionally outline remote measurement technologies designed delineate patients' illness recovery trajectories facilitate development intervention approaches.

Язык: Английский

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Cognitive bias modification training of attention and interpretation to reduce expectations of social rejection in adolescents with eating disorders: A small efficacy randomized controlled trial

International Journal of Eating Disorders, Год журнала: 2022, Номер 55(11), С. 1506 - 1520

Опубликована: Сен. 22, 2022

Abstract Objective This study aimed to investigate whether a computerized cognitive bias modification training delivered remotely would reduce expectations of rejection in adolescents with eating disorders. Method Sixty‐seven aged 12–18 (99.5% female) an disorder diagnosis (94% anorexia nervosa) and receiving specialist treatment were recruited. Participants randomized intervention condition ( n = 37) which included as usual (TAU) supplemented by nine sessions online for social stimuli (CBMT + TAU), or control 30), TAU only. invited complete assessments at baseline post‐intervention. Results In the condition, 22/37 participants completed six more post‐intervention measures, pre‐defined criteria be considered “completers.” 28/30 measures. who displayed significantly greater reduction negative interpretations ambiguous scenarios, medium effect size p .048, ηp2 .090), psychopathology, .027, .105), compared condition. No significant between‐group differences found on emotional response criticism, anxiety depression symptoms s > .05; small sizes). Discussion Enhancing CBMT targeting might feasible effective psychopathology Training adaptations necessary impact processing comorbid psychological distress. Public Significance Adolescents disorders brief (4‐week) intervention, alongside their treatment, reported reductions after separate group patients received accessible may helpful adjunct

Язык: Английский

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The effect of training to target cognitive biases towards social rejection in eating disorders

European Eating Disorders Review, Год журнала: 2024, Номер 32(4), С. 718 - 730

Опубликована: Март 8, 2024

Abstract Objective This study examined the effect of cognitive bias modification for interpretation (CBM‐I) training in Korean women with eating disorders (EDs). Method Sixty‐three EDs participated study. Participants were randomly assigned to intervention group where they received six sessions CBM‐I ( n = 31) addition treatment‐as‐usual or put on a waiting list 32). Participants' and attention biases, emotion regulation, affect, ED psychopathology assessed at baseline, end‐of‐intervention (4 weeks), follow‐up (8 weeks). Results who completed displayed greater reductions negative Δη 2 0.107) dysregulation 0.085) medium large sizes compared control group, which maintained from baseline follow‐up. Disengagement faces focus positive was found moderate size 0.090). Both groups showed improvements psychopathology. Baseline neuroticism positively correlated effect. Discussion The results suggest that modifying towards ambiguous social stimuli might be an effective adjuvant treatment reduce expectations situations improve regulation bulimia nervosa anorexia nervosa.

Язык: Английский

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Effect of modifying negative interpretation bias toward ambiguous social stimuli across eating and personality disorders

International Journal of Eating Disorders, Год журнала: 2023, Номер 56(7), С. 1341 - 1352

Опубликована: Март 23, 2023

Abstract Objective Heightened sensitivity toward social rejection has been implicated in eating disorders (ED) and personality disorder (PD). This study examined the effect of a cognitive bias modification training (CBM‐I) targeting interpretation ambiguous situations individuals with comorbid ED PD. Method A total 128 participants [33 PD, 22 ED‐only, PD‐only, 51 healthy controls (HC)] were recruited from hospital university settings, included final analyses. The randomly assigned to CBM‐I task benign resolutions or control neutral counterbalanced order two sessions using within‐subject design. Interpretation stimuli was measured sentence completion before after completing task. Results increased decreased negative interpretations large sizes diagnostic groups, moderate size HC group. Participants' anxiety levels also reduced change positively associated baseline affect, negatively positive affect. Discussion results suggest that modifying potential as transdiagnostic target treatment for fully powered clinical trial consecutive would be warranted. Public Significance Participants and/or disorder, completed single session intervention sensitivity. produced decrease controls. findings indicate processing information may value augment conditions such which there are high

Язык: Английский

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Acute Augmentations to Psychological Therapies in Eating Disorders: A Systematic Review and Meta-Analysis

Current Psychiatry Reports, Год журнала: 2024, Номер 26(9), С. 447 - 459

Опубликована: Авг. 2, 2024

The purpose of this systematic review and meta-analysis was to examine the use efficacy acute augmentation therapies in eating disorders.

Язык: Английский

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Treatment escalation for people with anorexia nervosa: setting, therapies and nutritional interventions

Current Opinion in Psychiatry, Год журнала: 2024, Номер 37(6), С. 404 - 416

Опубликована: Сен. 4, 2024

Purpose of review Adult patients with severe anorexia nervosa often receive the same unsuccessful treatment without changes regarding setting, therapies, or nutritional interventions. Recent findings Settings where people are treated include their general practitioner, an independent psychiatric practice, a community mental health team (CMHT), specialized eating disorder outpatient service, early intervention services, highly intensive home programme, daycare, inpatient hospital hospital, residential treatment. At should be offered evidence-based psychotherapy for nervosa, dietary advice and physical monitoring as first step. Additionally, they may allocated to specific pathway, family interventions creative therapies. As second step, clinicians consider integrating targeting comorbidities, medication noninvasive neurostimulation. After several years futile treatment, deep brain stimulation (DBS) considered prevent chronic course nervosa. Nutritional can escalated from counselling nasogastric tube feeding. Patients who rely on feeding might benefit percutaneous endoscopic gastrostomy (PEG). vomit despite tube, need nasojejunal Summary Treatment regularly reviewed and, if necessary, avoid longstanding disease course.

Язык: Английский

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Negative interpretation bias in females with bulimia nervosa

Mental Health Science, Год журнала: 2023, Номер 1(3), С. 195 - 201

Опубликована: Авг. 17, 2023

Abstract Persons with bulimia nervosa (BN) often experience psychosocial difficulties, in particular heightened sensitivity to social rejection and a negative bias toward their environment. Conversely, competence close friendships are protective against mental ill health. The aims of this study were evaluate the interpretation ambiguous scenarios females without BN assess relationship between biases clinical characteristics. Females ( n = 35) controls recruited via media. Participants completed Eating Disorder Examination Questionnaire (EDE‐Q), Adult Rejection Sensitivity Questionnaire, Depression Anxiety Stress Scales (DASS), finished sentence stems depicting scenarios. Completed rated as positive, neutral, or by blinded researchers. made fewer positive more interpretations than controls. frequency correlated positively symptoms on EDE‐Q, A‐RSQ, DASS. A was found BN, which aligns finding shown Cardi et al. that anorexia have This not only associated eating disorder psychopathology but also depression, anxiety, stress, highlighting potential transdiagnostic role. Interventions address difficulties might prevent onset, reduce symptoms, improve prognosis.

Язык: Английский

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Negative and positive interpretations of emotionally neutral situations modulate the desire to eat personally craved foods

Appetite, Год журнала: 2023, Номер 191, С. 107092 - 107092

Опубликована: Окт. 16, 2023

Язык: Английский

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Implication of Social Rejection in Cognitive Bias Modification Interpretation Training in Adolescents With Eating Disorders

Journal of korean Academy of Child and Adolescent Psychiatry, Год журнала: 2024, Номер 35(2), С. 101 - 106

Опубликована: Апрель 1, 2024

Objectives: Difficulties in interpersonal relationships intensify negative emotions and act as risk maintenance factors for eating pathology disorders.Rejection sensitivity refers to the tendency react sensitively a rejection.Patients with disorders experience difficulties because of their high rejection.Cognitive bias modification interpretation (CBM-I) is treatment developed correct social emotional stimuli.In this review, we searched research characteristics trends through systematic literature analysis CBM-I disorders.Methods: Five papers that met selection exclusion criteria were included final review analyzed according detailed topics (participant characteristics, design, results).Results: The supports efficacy reducing disorder psychopathology patients disorders.CBM-I targets dysregulation adolescent serves an additional strengthening psychotherapy alleviate symptoms. Conclusion:The current findings highlight potential individualized adjunctive adolescents functioning problems.

Язык: Английский

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Tratamiento de los factores temperamentales, motivacionales y socio-cognitivo-actitudinales en la población adolescente-jove. Revisión sistemática

International Journal of Developmental and Educational Psychology Revista INFAD de psicología, Год журнала: 2024, Номер 1(1), С. 339 - 349

Опубликована: Июль 23, 2024

Generalmente, la gran diversidad de tratamientos psicológicos que pueden influir en personalidad, el estado ánimo, motivación y las funciones cognitivas una persona ha sido ampliamente estudiado. En los últimos años surgido evidencia sobre aparición nuevos sus posteriores modificaciones adaptaciones para aplicarse a adolescentes o personas jóvenes así averiguar su efectividad este rango edad población. El objetivo esta investigación fue realizar revisión sistemática estudios registrados bases datos Web of Science (WOS) Pubmed aplicados dirigidos favorecer factores temperamentales, motivacionales sociocognitivos actitudinales. se incluyó 195 artículos científicos, utilizando metodología PRISMA analizar información obtenida. Los resultados arrojaron un incremento emergente publicaciones años, siendo año 2021 más documentos registra enla muestra seleccionada. Además, utilizados fueron aquellos paliar temperamentales. A pesar estos avances, análisis bibliométrico tema objeto estudio es escaso, futuros e investigaciones recomienda verificar revisiones disponer esos utilización.

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