International Journal of Eating Disorders最新文献

{"title":"The Potential of Small Effects at the Right Time, on a Large Scale: Commentary on Linardon et al. (2025).","authors":"Ata Ghaderi","doi":"10.1002/eat.24472","DOIUrl":"https://doi.org/10.1002/eat.24472","url":null,"abstract":"<p><p>The meta-analysis of self-help intervention for eating disorders (ED) by Linardon and colleagues showed significant, albeit small, effects favoring self-help over the control condition on depression, anxiety, distress, and self-esteem. Despite modest effect sizes, pure self-help offers the potential for high accessibility at low cost, which may lead to a meaningful impact on public health in terms of mental health symptoms that are often co-occurring with ED. There are opportunities to present and package pure self-help in more creative ways than what is currently available (e.g., by integrating brief instructional and experiential videos, infographics, storytelling, and compelling patient narratives). To fully harness the potential of pure self-help, disruptive innovations are necessary in both the packaging and delivery methods. These innovations can help to accommodate various needs, learning styles, and preferred delivery formats. A consortium dedicated to pure self-help for symptoms of ED and its prevention can play a vital role in testing, delivering, collecting big data, understanding moderators of outcomes, and facilitating adaptation and further development, thereby improving access to these interventions and leading to better mental health.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adapting Barlow's Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Overweight Adults: A Nonrandomized Controlled Feasibility Study.","authors":"Leonor P Gawron, Kevin Rodríguez Clifford, Alba Ramírez Guillén, Mar Carceller-Sindreu, Cristina Carmona Farrés, Caterina Del Mar Bonnin, Maria J Portella","doi":"10.1002/eat.24474","DOIUrl":"https://doi.org/10.1002/eat.24474","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the feasibility and potential effectiveness of the Unified Protocol for Emotional Eating (UP-EE) in a group format.</p><p><strong>Method: </strong>Fifty-seven participants exhibiting high to severe emotional eating (EE) were assigned to an 8-week group intervention or to a control group receiving treatment as usual (TAU). EE (measured with the Dutch Eating Behavior Questionnaire) was the primary outcome, while state anxiety (State-Trait Anxiety Inventory [STAI-S]), depression (Beck Depression Inventory [BDI-II]) and perceived stress (Perceived Stress Scale [PSS-14]) were the secondary measures, assessed at baseline and post-intervention, or 8 weeks later in the control group. Satisfaction was measured via the Client Satisfaction Questionnaire (CSQ-8). Effectiveness was estimated using a linear mixed-effects model.</p><p><strong>Results: </strong>The UP-EE received positive feedback and achieved an acceptable treatment retention. There were no significant differences regarding sociodemographic and clinical characteristics between groups. While both groups were not significantly different at the end of the intervention, the waitlist group worsened in anxiety, depression, and perceived stress, and showed only a slight improvement in EE. In contrast, the intervention group showed significant improvements across these variables, with a sharper decrease in EE. Results were consistent across both per-protocol and intention-to-treat analyses.</p><p><strong>Conclusions: </strong>A group UP-EE intervention is a feasible intervention. Future research should focus on a larger sample with a randomized controlled trial design and utilize measures of disordered eating to more clearly identify the superiority of the intervention over a comparison condition.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PTSD and Complex PTSD in Residential Treatment for Eating Disorders: Moderating Effects on Symptom Severity and Outcome Trajectory.","authors":"Sinead Day, Deborah Mitchison, W Kathy Tannous, Phillipa Hay","doi":"10.1002/eat.24465","DOIUrl":"https://doi.org/10.1002/eat.24465","url":null,"abstract":"<p><strong>Objective: </strong>Eating disorders (EDs) and symptoms of trauma commonly co-occur, yet research is limited on how trauma affects ED treatment outcomes. This is particularly true for complex post-traumatic stress disorder (CPTSD). Differentiating between the treatment impacts of PTSD and CPTSD (which includes both PTSD symptoms and disturbances in self-organization [DSO]) may help ED providers address this common comorbidity.</p><p><strong>Method: </strong>The current study included 95 women (M_age = 26 years) with EDs (largely anorexia nervosa) who received residential treatment (M = 81 days). Participants completed measures of ED symptoms, anxiety, depression, body mass index (BMI), ED-specific health-related quality-of-life (ED-HRQoL) impairment, functional disability, and trauma symptoms at admission, week 4 of treatment, discharge, and 6 months post-discharge.</p><p><strong>Results: </strong>All outcomes except BMI were more severe at admission and week 4 of treatment for individuals with comorbid trauma (based on probable CPTSD or exceeding the clinical threshold for PTSD and DSO symptom domains); however, these differences resolved by discharge and remained non-significant at follow-up. Some forms of comorbid trauma moderated outcome trajectories for anxiety, depression, and disability (but not ED symptoms), such that individuals with comorbid trauma showed slower improvement early in treatment, steeper improvement later in treatment, and greater resurgence after discharge.</p><p><strong>Discussion: </strong>These findings highlight that PTSD and CPTSD symptom domains may be associated with more severe ED outcomes early in residential treatment that resolve by discharge, and may predict differential treatment response for secondary outcomes. Implications are discussed for clinical assessment and treatment of comorbid trauma-related disorders in residential care.</p><p><strong>Trial registration: </strong>The study was prospectively registered on the Australian and New Zealand Clinical Trials Registry in November 2021, registration number ACTRN12621001651875.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"If There Are Restrictions Within the Restrictions, That's When You Can Probably Get Concerned\": Key Indicators for Untying Vegetarianism and Veganism From Eating Disorder Pathology.","authors":"Courtney P McLean, Kathleen de Boer, Megan Bray","doi":"10.1002/eat.24475","DOIUrl":"https://doi.org/10.1002/eat.24475","url":null,"abstract":"<p><strong>Objective: </strong>Changes in eating patterns and/or food exclusion strategies, including the uptake of vegetarianism and veganism, may reflect disordered behaviors and attitudes in people with eating disorders. For this reason, health professionals often attempt to assess whether a client's vegetarianism or veganism is tied to, or driven by, their eating disorder. Yet this may be difficult considering a lack of formally recognized guidelines for the treatment of vegetarians and vegans with an eating disorder, meaning that often a one-size-fits-all approach to treating these groups is employed. This study aimed to integrate lived eating disorder perspectives to qualitatively inform indicators of potential pathological vegetarian or vegan adherence in people with an eating disorder.</p><p><strong>Method: </strong>Seventeen participants (aged 19-48, 76% [n = 13] female, 47.06% [n = 8] vegetarian) with a history of receiving eating disorder treatment were recruited.</p><p><strong>Results: </strong>Five themes were identified: (1) Timing matters, (2) Explore motivations for dietary adherence, (3) Fear reaction causes for concern, (4) Flexibility within vegetarianism or veganism, and (5) Hold space for eating disorder deception.</p><p><strong>Discussion: </strong>Our findings demonstrate several key indicators that may be useful areas of discussion in clinical practice when working with vegetarian and vegan clients. Being able to potentially quantify genuine vegetarian or vegan adherence from eating disorder-driven behaviors and attitudes provides a valuable stepping stone to the future development of clinical guidelines for the treatment of people adhering to these dietary groups.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ecological Momentary Assessment in Eating Disorders Research: A Qualitative Examination of Participant Experience and Recommendations for Future Studies.","authors":"Samantha Wilson, Laura Lapadat, Lisa Y Zhu, Sarah E Racine","doi":"10.1002/eat.24473","DOIUrl":"https://doi.org/10.1002/eat.24473","url":null,"abstract":"<p><strong>Objective: </strong>Ecological momentary assessment (EMA) is a widely-used research method for investigating temporal relationships among eating disorder (ED) symptoms. Though EMA has many methodological advantages (e.g., reducing retrospective recall bias), little is known about the experience and effects of participating in this type of study from the perspective of individuals with EDs. The present study aimed to examine the experience of participants with EDs after completing an EMA study, with the goal of elucidating potential positive and negative effects of EMA methodology.</p><p><strong>Method: </strong>A heterogeneous sample of participants with EDs (N = 192) completed clinical interviews, questionnaires, and an EMA protocol (five surveys/day for 14 days). A subsample of these participants (n = 16) completed a qualitative interview exploring their experience participating in the study. A reflexive thematic analysis was conducted using Nvivo software.</p><p><strong>Results: </strong>The following themes were identified: (1) Self-awareness, mindfulness, and reflection; (2) Behavioral change; (3) Rewarding aspects of the study; (4) Challenging aspects of the study; (5) Study design (including facilitators and barriers to participating); and (6) Suggestions for future studies.</p><p><strong>Discussion: </strong>Although participants reported some challenging aspects of the study, most described their experience as positive (or at least neutral), and many noted direct benefits of participating. Future EMA research may benefit from integrating the perspectives of those with lived experience into study design, potentially reducing participant burden, improving the quantity and quality of data collected, and increasing benefits for participants.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on \"Next Steps in Use of the Eating Disorder Examination and Related Eating Disorder Assessments: A Call for Consensus\" by Reilly et al.","authors":"Phillipa J Hay","doi":"10.1002/eat.24471","DOIUrl":"https://doi.org/10.1002/eat.24471","url":null,"abstract":"<p><p>The purpose of this Commentary is to expand upon Reilly et al. 2025's critique of the Eating Disorder Examination (EDE) around a dialectic of its major strengths and its limitations. Although notable strengths of the EDE are its diagnostic case identification and detailed assessment of phenomenology, its resource intensity (training and administration) may explain why researchers and clinicians often prefer to use the EDE-Q-the self-report version of the EDE. An example of this is in the development of a national eating disorder assessment package for residential care in Australia, where the EDE-Q (not the EDE) was recommended by a committee of eating disorder experts advising the Federal Government, and subsequently the EDE-Q was used by researchers in the clinical evaluation of the first Australian residential program. The present and future need for multidimensional assessments beyond symptoms is presented. A proposal for a global consensus on harmonization of constructs in eating disorder assessment, matching a repertoire of relevant instruments suited to diverse times and places, is suggested.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Disgust, Body-Related Attentional Bias and Body Dissatisfaction: A Virtual Reality and Eye-Tracking Exploration.","authors":"Mariarca Ascione, Klaske A Glashouwer, Franck-Alexandre Meschberger-Annweiler, María Teresa Mendoza-Medialdea, Bruno Porras-Garcia, Marta Ferrer-Garcia, José Gutierrez-Maldonado","doi":"10.1002/eat.24467","DOIUrl":"https://doi.org/10.1002/eat.24467","url":null,"abstract":"<p><strong>Objective: </strong>This study examines the relationships between self-disgust, body dissatisfaction (BD), and attentional biases (AB) toward weight-related body areas, exploring whether self-disgust predicts attentional avoidance and moderates the relationship between BD and AB.</p><p><strong>Method: </strong>Using virtual reality and eye-tracking technology, 78 female students viewed their virtual bodies in a mirror to assess gaze patterns as an indicator of attentional bias.</p><p><strong>Results: </strong>BD was positively associated with both AB and self-disgust. Contrary to expectations, self-disgust correlated with increased attention to weight-related areas rather than avoidance and did not moderate the BD-AB relationship.</p><p><strong>Discussion: </strong>These findings suggest that self-disgust may reinforce attention toward weight-related areas, contributing to negative body image. Future research should explore these mechanisms in clinical populations to inform targeted interventions.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanisms of Change in Cognitive-Behavioral Therapy for Adults With Binge-Eating Disorder: A Dynamic Structural Equation Modeling Approach.","authors":"Ricarda Schmidt, Danielle Schewe, Stephan Herpertz, Stephan Zipfel, Brunna Tuschen-Caffier, Hans-Christoph Friederich, Andreas Mayr, Martina de Zwaan, Anja Hilbert","doi":"10.1002/eat.24469","DOIUrl":"https://doi.org/10.1002/eat.24469","url":null,"abstract":"<p><strong>Objective: </strong>Cognitive-behavioral therapy (CBT) is the most well-established treatment for binge-eating disorder (BED), but the mechanisms of change remain poorly understood. This study investigated in CBT for BED the effects of overvaluation of shape and weight and dietary restraint on subsequent objective binge-eating episodes (OBEs).</p><p><strong>Method: </strong>In a multicenter randomized-controlled trial, 84 patients diagnosed with full- or subsyndromal BED were offered 20 individual sessions of CBT over 4 months. Dynamic structural equation modeling (DSEM) was used to disentangle within- and between-patient associations of overvaluation of shape and weight, dietary restraint, and OBEs.</p><p><strong>Results: </strong>Between the first and last week of therapy, there were significant reductions in overvaluation of shape and weight, dietary restraint, and OBEs. DSEM showed significant within-patient effects of overvaluation of shape and weight on the subsequent number of OBEs. Weeks with lower overvaluation of shape and weight levels were followed by weeks with fewer OBEs. Although no within-patient effect of dietary restraint on OBEs was found, within-patient dietary restraint levels positively predicted subsequent overvaluation of shape and weight levels.</p><p><strong>Discussion: </strong>The findings suggest that reductions in overvaluation of shape and weight may precede improvements in binge eating during CBT for BED, supporting its role as a potential mechanism of change. While dietary restraint did not show a direct temporal link to binge eating, its association with overvaluation points to a potential indirect role. These results underscore the value of targeting cognitive features of BED in CBT and highlight the need for more temporally sensitive assessments in mechanisms research.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Artificial Intelligence and Smartphone Technology to Enhance Personalized Assessment and Treatment for Eating Disorders.","authors":"Jake Linardon, John Torous","doi":"10.1002/eat.24468","DOIUrl":"https://doi.org/10.1002/eat.24468","url":null,"abstract":"<p><strong>Objective: </strong>Smartphone technology presents a promising path toward expanding access to evidence-based eating disorder assessment and treatment. Despite rapid technological advances, research has yet to harness these systems in ways that make personalized digital health care a clinical reality. In this forum, we review extant research testing smartphone intervention and monitoring tools for eating disorders and explore innovative ways integrating this technology with AI can enhance assessment, symptom detection, and intervention efforts.</p><p><strong>Method: </strong>We highlight three capabilities of smartphones that hold promise for delivering personalized and maximally effective digital health tools: (1) passive sensing and digital phenotyping; (2) natural language processing of reflections from in-app homework tasks; and (3) closed-loop adaptive interventions. We discuss how these capabilities can augment current assessment and treatment efforts and draw on literature from other fields to inform research questions for the eating disorder field.</p><p><strong>Results: </strong>Evidence from other fields demonstrates the feasibility of constructing data-driven models from smartphone sensor data and textual input from in-app CBT activities to predict clinical outcomes. These models may inform closed-loop interventions, enabling apps to deliver timely, personalized support in response to real-time changes in a user's needs.</p><p><strong>Conclusion: </strong>The eating disorder field can draw on lessons from other fields to evaluate smartphone technology that leverages AI to enhance personalization. Realizing the potential of these tools will require addressing challenges related to engagement, trust, data governance, and clinical integration. The testable research questions presented here offer a roadmap to guide future large-scale, collaborative efforts aimed at transforming eating disorder care.</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maze-Out: A Serious Game to Enhance Treatment for Eating Disorders. A Randomized Controlled Trial.","authors":"Maria Mercedes Guala, Aida Bikic, Kim Bul, David Clinton, Anna Mejdal, Helene Nygaard Nielsen, René Klinkby Støving, Anette Søgaard Nielsen","doi":"10.1002/eat.24458","DOIUrl":"https://doi.org/10.1002/eat.24458","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the effectiveness of Maze Out, a serious game (SG) codesigned by patients with eating disorders (ED) and clinicians as an adjunct to treatment as usual (TAU) for improving self-efficacy, self-image, and engagement in individuals with ED. Effects on ineffectiveness, insecurity, and personal recovery were also examined.</p><p><strong>Method: </strong>A randomized controlled trial (RCT) was conducted at 11 centers in Denmark between July 2022 and December 2023. A total of 133 adult participants (≥ 18 years) with a registered ICD-10 ED diagnosis were randomized (1:1) to receive Maze Out plus TAU or TAU alone for 15 weeks. Assessments were conducted at baseline, 8 and 15 weeks. The primary outcome was self-efficacy, while the secondary outcomes included self-image, feelings of ineffectiveness and insecurity, and personal recovery. Data were analyzed using linear mixed-effects models under both intention-to-treat (ITT) and complete-case approaches.</p><p><strong>Results: </strong>ITT analysis revealed no significant differences between the groups on primary or secondary outcomes. Complete-case analysis, however, showed significant improvements in personal recovery (mean difference 5.81 [95% CI 0.25-11.37]; p = 0.040) and reductions in negative self-image, including self-blame (-13.06 [-24.18 to -1.95]; p = 0.021) and self-neglect (-14.59 [-28.01 to -1.17]; p = 0.033), in the intervention group. Engagement was high, indicating meaningful interaction with the game.</p><p><strong>Discussion: </strong>Although no overall effects were found in ITT analyses, improvements in personal recovery and self-image support the potential of Maze Out as a feasible and acceptable adjunct to TAU. Further research should assess long-term and subgroup-specific effects.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT05621018, and the protocol was published (Guala, Bikic, Bul, Clinton, Mejdal, et al. 2024).</p>","PeriodicalId":51067,"journal":{"name":"International Journal of Eating Disorders","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}