Journal of Eating Disorders最新文献

{"title":"Lymphocyte subsets and the increased risk for opportunistic infections in severe restrictive anorexia nervosa.","authors":"Petra Vidmar, Josje Altenburg, Ester M van Leeuwen, Annemarie C M van Bellegem, Chantal Verhoef, Godelieve J de Bree, Maarten R Soeters","doi":"10.1186/s40337-025-01235-9","DOIUrl":"10.1186/s40337-025-01235-9","url":null,"abstract":"<p><p>Restrictive anorexia nervosa (AN-R) is characterized not only by psychiatric manifestations but also by significant medical complications. Patients commonly exhibit immune alterations, potentially increasing their susceptibility to infections. While direct evidence linking AN-R to heightened rates of opportunistic infections remains inconclusive, clinical observations suggest a higher incidence of complications and delayed febrile response in patients with infections. Concurrently, malnutrition, a frequent cause of secondary immunodeficiencies, exacerbates this susceptibility by compromising immune function. This paper investigates the immunological profiles of two patients with long-term AN-R who developed severe infections: one with disseminated Mycobacterium kansasii and the other with a co-infection of pulmonary Aspergillus fumigatus and Mycobacterium celatum. These cases, alongside data collected from previously published case reports summarized in this study, highlight the impact of altered immune function associated with mentioned population. The paper aims to explain the underlying mechanisms of immune dysfunction. Proactive monitoring of immune status and incorporating such assays into clinical practice may benefit early detection, effective management, and ultimately, improved outcomes.</p>","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"13 1","pages":"84"},"PeriodicalIF":3.5,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monitoring neutrophil-to-lymphocyte ratio dynamics for personalized treatment in adolescent eating disorders: a retrospective cohort study.","authors":"Yuta Inagawa, Kazumi Kurata, Seiji Obi, Yoshiyuki Onuki, Yukifumi Monden, Koyuru Kurane, Rieko Furukawa, Tadahiro Mitani, Hirotaka Nakamura, Shiro Suda, Tatsuhiko Yagihashi","doi":"10.1186/s40337-025-01282-2","DOIUrl":"10.1186/s40337-025-01282-2","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the dynamics of the neutrophil-to-lymphocyte ratio (NLR) during the initial hospitalization of patients with eating disorders (EDs) and to assess its potential as a biomarker for monitoring disease severity and treatment response.</p><p><strong>Methods: </strong>A retrospective chart review was conducted with 55 patients aged ≤ 16 years diagnosed with anorexia nervosa or avoidant/restrictive food intake disorder and admitted to Jichi Medical University Hospital between 2015 and 2021. Sociodemographic and clinical characteristics including sex, age, rate of weight gain, percentage of ideal body weight (%IBW), tube feeding treatment, and NLR were obtained. Statistical analyses used a mixed model for repeated measures to assess NLR changes regarding %IBW and other clinical factors.</p><p><strong>Results: </strong>The NLR at admission was lower in the malnourished state but increased with weight recovery. MMRM revealed that tube feeding treatment (β = 0.538) and restoration of %IBW (β = 0.029) significantly predicted an increase in the NLR. The interaction between tube feeding and the quadratic term of %IBW was also significant, indicating distinct patterns of NLR changes: without tube feeding, NLR increased linearly with weight recovery, whereas with tube feeding, NLR exhibited a non-linear, upward-convex parabolic trend.</p><p><strong>Discussion: </strong>These findings suggest that NLR may offer an objective recovery marker less influenced by patient self-report. Monitoring NLR before and after tube feeding may help distinguish true physiological recovery from transient stress responses, providing complementary information to conventional assessments. Further research is warranted to establish its clinical relevance.</p>","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"13 1","pages":"86"},"PeriodicalIF":3.5,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factor structure, internal consistency, and measurement invariance of the Eating Pathology Symptoms Inventory (EPSI) in a national U.S. sample of cisgender gay men and lesbian women.","authors":"Jason M Nagata, Christopher D Otmar, Angela E Kim, Emilio J Compte, Jason M Lavender, Tiffany A Brown, Kelsie T Forbush, Annesa Flentje, Micah E Lubensky, Mitchell R Lunn, Juno Obedin-Maliver","doi":"10.1186/s40337-025-01277-z","DOIUrl":"https://doi.org/10.1186/s40337-025-01277-z","url":null,"abstract":"<p><strong>Background: </strong>The Eating Pathology Symptoms Inventory (EPSI) is a questionnaire that assesses the severity of eating-disorder symptoms. This study aimed to examine the factor structure and measurement invariance of the EPSI in a large national U.S. sample of cisgender gay men and lesbian women.</p><p><strong>Methods: </strong>The sample consisted of 1,498 cisgender sexual minority adults, including cisgender gay men (n = 925) and cisgender lesbian women (n = 573), who completed online self-report surveys. Using a split-half approach, exploratory factor analysis (EFA) was conducted in the first subset of each sample to identify underlying factor structures, followed by confirmatory factor analysis (CFA) to confirm model fit in the second subset of each sample. Multi-group confirmatory factor analysis (MG-CFA) was used to assess measurement invariance across the two sexual minority groups.</p><p><strong>Results: </strong>The EPSI eight-factor structure was supported across both cisgender sexual minority groups with strong model fit: cisgender gay men (CFI = 0.96, RMSEA = 0.04, SRMR = 0.06) and cisgender lesbian women (CFI = 0.94, RMSEA = 0.05, SRMR = 0.07). Measurement invariance analyses indicated that the EPSI was invariant across groups. Internal consistency, assessed using McDonald's omega, was acceptable for all scales (ωs = 0.75 to 0.95).</p><p><strong>Conclusions: </strong>This study provides support for the utility of the EPSI in cisgender gay men and lesbian women populations, including measurement invariance that allows for meaningful comparisons across groups. Specifically, the EPSI performs reliably and consistently as a measure of eating pathology across adult cisgender gay men and cisgender lesbian women.</p>","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"13 1","pages":"83"},"PeriodicalIF":3.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating fecal microbiota transplants from individuals with anorexia nervosa in antibiotic-treated mice using a cross-over study design.","authors":"Sina Maschek, Theresa Helena Østergaard, Lukasz Krych, Line Fisker Zachariassen, Dorte Bratbo Sørensen, Caroline M Junker Mentzel, Axel Kornerup Hansen, Jan Magnus Sjögren, Kenneth Klingenberg Barfod","doi":"10.1186/s40337-025-01276-0","DOIUrl":"10.1186/s40337-025-01276-0","url":null,"abstract":"<p><p>Anorexia nervosa (AN) is a complex and serious mental disorder, which may affect individuals of all ages and sex, but primarily affecting young women. The disease is characterized by a disturbed body image, restrictive eating behavior, and a lack of acknowledgment of low body weight. The underlying causes of AN remain largely unknown, and current treatment options are limited to psychotherapy and nutritional support. This paper investigates the impact of Fecal Microbiota Transplants (FMT) from patients with AN on food intake, body weight, behavior, and gut microbiota into antibiotic-treated mice. Two rounds of FMT were performed using AN and control (CO) donors. During the second round of FMT, a subset of mice received gut microbiota (GM) from a different donor type. This split-group cross-over design was chosen to demonstrate any recovery effect of FMT from a non-eating disorder state donor. The first FMT, from donors with AN, resulted in lower food intake in mice without affecting body weight. Analysis of GM showed significant differences between AN and CO mice after FMT1, before cross-over. Specific bacterial genera and families Ruminococcaceae, Lachnospiraceae, and Faecalibacterium showed different abundances in AN and CO receiving mice. Behavioral tests showed decreased locomotor activity in AN mice after FMT1. After FMT2, serum analysis revealed higher levels of appetite-influencing hormones (PYY and leptin) in mice receiving AN-GM. Overall, the results suggest that AN-GM may contribute to altered food intake and appetite regulation, which can be ameliorated with FMT from a non-eating disorder state donor potentially offering FMT as a supportive treatment for AN.</p>","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"13 1","pages":"82"},"PeriodicalIF":3.5,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Listening and learning: the need for a compassionate and patient-centered approach for longstanding AN.","authors":"Jennifer L Gaudiani","doi":"10.1186/s40337-025-01279-x","DOIUrl":"10.1186/s40337-025-01279-x","url":null,"abstract":"<p><p>A 2022 paper proposing preliminary clinical characteristics of adults with anorexia nervosa who might be supported in compassionate end-of-life care generated public dissent in the peer-reviewed literature and the media as well as private expressions of support. Several years of listening and learning by the lead author resulted in a greater understanding of personal, clinical, and scholarly concerns that arose as a result of this article. In this piece, the lead author expressly disavows the concept and phrase of \"terminal anorexia nervosa.\" This essay attempts to acknowledge the original article's inadequacies, aims to bring clarity and specificity to the issue, and calls for ongoing discussions and collaboration to improve treatment for our complex and vulnerable patients.</p>","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"13 1","pages":"81"},"PeriodicalIF":3.5,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"I thought if my parents got involved, then they'd make me get better\": emerging adults' experiences of support from family and friends during anorexia nervosa.","authors":"Rachel Potterton, Gary Brown, Ulrike Schmidt","doi":"10.1186/s40337-025-01260-8","DOIUrl":"10.1186/s40337-025-01260-8","url":null,"abstract":"<p><strong>Background: </strong>Around half of all eating disorder cases start during emerging adulthood (i.e., 18-25 years of age). This is an important time of change in interpersonal relationships, marked by individuation from the family of origin. Interpersonal relationships have long featured in theories of eating disorder maintenance and recovery. Increased understanding of the interplay between eating disorders and changes in the interpersonal domain may be key to improving the efficacy of existing treatments and developing novel interventions for this population group.</p><p><strong>Objective: </strong>This study aimed to explore experiences of support from family and friends amongst emerging adults with anorexia nervosa.</p><p><strong>Methods: </strong>A convenience sample of emerging adults who had received specialist treatment for anorexia nervosa in the United Kingdom (N = 10) was recruited via advertisements on social media. Semi-structured interviews were conducted focusing on experiences of support from family and friends during their eating disorder. Data were analysed using Interpretative Phenomenological Analysis.</p><p><strong>Results: </strong>Five key themes in participants' experiences were identified: (i) feeling isolated and lacking close friends; (ii) resisting involvement of family due to perceiving them as part of the problem; (iii) feeling family and friends' feelings; (iv) desiring flexible boundaries, and (v) feeling ambivalent towards family and friends' lived experience.</p><p><strong>Conclusions: </strong>Findings suggest a complex entanglement of development of and recovery from AN with the process of individuating from parents during emerging adulthood. Clinicians may find benefit in helping emerging adults to develop their independence and supporting parents to adopt helpful emotional and behavioural postures that tackle the AN maintenance cycle, for example developing parental emotion regulation skills and supporting parents to facilitate age-appropriate levels of independence and responsibility.</p>","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"13 1","pages":"80"},"PeriodicalIF":3.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empirical validation of a developmental model for binge-eating disorder in adolescents: a structural equation modeling approach.","authors":"Camille Clermont, Christopher Rodrigue, Catherine Bégin","doi":"10.1186/s40337-025-01240-y","DOIUrl":"https://doi.org/10.1186/s40337-025-01240-y","url":null,"abstract":"<p><p>Loss of control (LOC) eating is characterized by a reported sense of being unable to control food intake, regardless of the amount of food consumed. It is the hallmark feature of binge-eating episodes, which involve consuming an unusually large amount of food within a discrete time frame, accompanied by a sense of LOC over eating. Some studies investigating the progression of LOC-eating symptoms in children and adolescents suggest that LOC-eating may be a precursor to binge-eating disorder (BED) in adults. To explain the progression from LOC-eating in childhood and adolescence to BED in adulthood, Tanofsky-Kraff and her colleagues developed a theoretical model highlighting three main constructs: negative affectivity, reward sensitivity, and executive functioning. However, a thorough empirical validation of this model has not yet been performed. The current study aims to empirically test Tanofsky-Kraff and her colleagues' model via structural equation modeling (SEM) and explore potential gender and age differences within this framework. We surveyed 969 adolescents aged 12 to 18 years from the Quebec City area who completed self-report questionnaires. Our findings revealed that both negative affectivity and reward sensitivity are significantly associated with binge-eating symptomatology, whereas self-reported executive functioning is not significantly associated with binge-eating symptomatology. These results support several key components of the proposed model and provide insights into the interactions between the variables when tested simultaneously. Additionally, our study underscores the importance of considering individual factors such as age and gender in understanding binge-eating symptomatology.</p>","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"13 1","pages":"79"},"PeriodicalIF":3.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Premature termination of eating disorder treatment - a qualitative study of therapist perspectives.","authors":"Oda Ulven, Signe Hjelen Stige, Yngvild Sørebø Danielsen","doi":"10.1186/s40337-025-01268-0","DOIUrl":"https://doi.org/10.1186/s40337-025-01268-0","url":null,"abstract":"<p><strong>Background: </strong>High dropout rates are a problem in eating disorder treatment and the knowledge about how therapists who work in this field understand and intervene to reduce drop out is scarce. The aim of this study was to explore how therapists understand and work to prevent dropout during eating disorder treatment.</p><p><strong>Methods: </strong>Five focus group interviews with a total number of 17 therapists were conducted. The therapists all worked in specialized mental health care and had different occupational backgrounds, including psychologists, specialist nurses, and doctors. All of them reported receiving training in CBT-E. Transcripts were analysed using a reflexive thematic analysis.</p><p><strong>Results: </strong>Our analysis resulted in the development of three main themes: (1) Accepting dropout; (2) Balancing resources; and (3) Recognizing the demands of treatment.</p><p><strong>Conclusions: </strong>Our findings suggest that preparation for treatment is conceptualized by therapists as something quite separate from treatment itself and as crucial for preventing dropout and providing good treatment results. Interestingly, interventions and processes during treatment received much less focus in the discussions among therapists during the interviews.</p><p><strong>Trial registration: </strong>This project has been approved by Regional Committees for Medical and Health Research Ethics in Norway (REK), REK-number 55,304.</p>","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"13 1","pages":"76"},"PeriodicalIF":3.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The weight of words: investigating the role of weight stigma and body mass index in shaping children and youth's emotional experiences.","authors":"Abdelaziz Hendy, Sahar M Soliman, Hyam Tantawi, Samira Salman, Rasha Kadri Ibrahim, Ahmed Hendy, Hadya Abboud Abdel Fattah, Khalid Al-Mugheed, Salwa Sayed, Amany Anwar Saeed Alabdullah, Sally Mohammed Farghaly Abdelaliem, Ahmed Zaher","doi":"10.1186/s40337-025-01248-4","DOIUrl":"https://doi.org/10.1186/s40337-025-01248-4","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of overweight and obesity among children and adolescents has become a significant public health concern worldwide. These conditions not only affect physical health but also contribute to psychological challenges, particularly through weight stigma. Understanding the relationship between weight stigma, body mass index (BMI), and emotional distress is crucial for informing interventions, particularly in cultural contexts where weight-related perceptions vary.</p><p><strong>Aim: </strong>This study aimed to investigate the influence of weight stigma and BMI on the emotional experiences of children and youth in Egypt.</p><p><strong>Methods: </strong>A descriptive correlational design was employed in 16 preparatory schools, 49 secondary schools, and 20 faculties across various Egyptian governorates. A convenience sample of 2,731 participants aged 12-21 years was included. Data were collected using an online questionnaire that measured BMI, weight stigma, and emotional states (depression, anxiety, and stress) through validated tools. Statistical analyses included chi-square and linear regression tests.</p><p><strong>Results: </strong>The findings revealed that 22% of participants experienced high levels of weight stigma, which was significantly associated with higher levels of emotional distress (p < 0.001). Weight stigma explained 46.9% of the variance in emotional distress, whereas BMI showed no significant association with emotional states (p = 0.983). Notably, cultural factors, including conflicting societal norms regarding body weight and media influence, appeared to shape weight perceptions and stigma experiences among youth.</p><p><strong>Conclusion: </strong>Weight stigma is a stronger predictor of emotional distress than BMI, emphasizing the need for targeted interventions addressing weight-based discrimination. Given the cultural nuances influencing weight perception in Egypt, public health initiatives should incorporate culturally sensitive approaches to promote body positivity and mitigate the psychological impact of stigma. These findings contribute to global eating disorder research by highlighting the role of sociocultural factors in shaping weight-related experiences among youth.</p>","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"13 1","pages":"73"},"PeriodicalIF":3.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emotional overload in Bulimia Nervosa: an ERP study of emotion processing and regulation.","authors":"L Vuillier, Z Wang, S Hassan, A Harrison, M P Somerville, X He","doi":"10.1186/s40337-025-01245-7","DOIUrl":"https://doi.org/10.1186/s40337-025-01245-7","url":null,"abstract":"<p><strong>Objective: </strong>People with Bulimia Nervosa (BN) self-report difficulties processing and regulating emotions. However, self-reports have been shown to be biased, particularly with people with BN who have difficulties describing their emotions. Self-reports also cannot easily disentangle between early processing and later regulatory stages, so it is not clear whether people with BN really do process their emotions more intensely or whether this is due to the aftermath of regulatory difficulties. This study aimed to use an objective way to measure (1) whether people with BN process their emotions with higher intensity compared to healthy controls (HC) and (2) whether they can successfully implement an emotion regulation strategy called cognitive reappraisal.</p><p><strong>Methods: </strong>We developed a neuroimaging task using electroencephalography to answer these questions, using the Late Positive Potential (LPP) as an objective measure of emotional arousal at the processing and regulatory stages. We tested the task in females with BN (N = 32) and matched HC (N = 35).</p><p><strong>Results: </strong>We found that our BN group showed higher LPP compared to our HC group when viewing emotional pictures, demonstrating increased emotional intensity at the processing stage. We also found that the LPP for reappraisal took longer to get back to baseline for our BN group compared to the maintain condition and our HC group.</p><p><strong>Discussion: </strong>Our results suggest that people with BN process their emotions with higher intensity and may struggle to implement subsequent cognitive reappraisal strategies when affect is high. This has direct implications for clinicians who should be aware that when evoking affect in treatment, people with BN may need greater support in understanding and managing their emotions. Clinicians may also want to offer distress tolerance skills to reduce emotional arousal before suggesting using cognitive reappraisal skills to manage strong emotions.</p>","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"13 1","pages":"74"},"PeriodicalIF":3.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}