A Pilot Open Trial of a Digital Mindfulness-Based Intervention for Anorexia Nervosa

Anorexia nervosa (AN) is a chronic and debilitating psychiatric disorder. Unfortunately, current treatments are lacking, with only 30-50% of individuals with AN recovering after treatment. We developed a beta-version of a digital mindfulness-based intervention for AN called Mindful Courage-Beta, which includes: (a) one foundational multimedia module; (b) 10 daily meditation mini-modules; (c) emphasis on a core skill set called the BOAT (Breathe, Observe, Accept, Take a Moment); and (d) brief phone coaching for both technical and motivational support. In this open trial, we aimed to evaluate (1) acceptability and feasibility; (2) intervention skill use and its association with state mindfulness in daily life; and (3) pre-to-post changes in target mechanisms and outcomes. Eighteen individuals with past-year AN or past-year atypical AN completed Mindful Courage-Beta over 2 weeks. Participants completed measures of acceptability, trait mindfulness, emotion regulation, eating disorder symptoms, and body dissatisfaction. Participants also completed ecological momentary assessment of skill use and state mindfulness. Acceptability ratings were good (ease-of-use: 8.2/10, helpfulness: 7.6/10). Adherence was excellent (100% completion for foundational module and 96% for mini-modules). Use of the BOAT in daily life was high (1.8 times/day) and was significantly associated with higher state mindfulness at the within-person level. We also found significant, large improvements in the target mechanisms of trait mindfulness (d = .96) and emotion regulation (d = .76), as well as significant, small-medium to medium-large reductions in eating disorder symptoms (ds = .36–.67) and body dissatisfaction (d = .60). Changes in trait mindfulness and emotion regulation had medium-large size correlations with changes in global ED symptoms and body dissatisfaction (rs = .43 – .56). Mindful Courage-Beta appears to be promising and further research on a longer, refined version is warranted.     

Food wrenching and dodging: Eating time estimates influence dodge probability and amplitude

Eating rats dodge conspecifics, who are trying to steal their food, by making a somewhat stereotyped 180° turn and step movement to block the robber's approach. This experiment examined the effect of food features on the form and vigor of the dodging movement. Dodge probability and its amplitude were measured as a function of food size, elapsed eating time, food hardness, and the way in which food theft was attempted. Under all conditions dodge probability and its amplitude were directly related to the time necessary to complete eating. Thus, rats estimated the time required to complete eating and adjusted the size of their evasive movements to gain this time. The results show that although dodging has the appearance of a fixed-action pattern, it is influenced by cognitive processes that may be similar to those that direct other aspects of foraging behavior. © 1994 Wiley-Liss, Inc.     

Loneliness,eating, and body mass index in parent–adolescent dyads from the Family Life,Activity, Sun,Health, and Eating study

Loneliness is a salient risk factor for obesity, emotional eating, and poor diet. Because adolescents and parents are embedded within a family unit, their experiences of loneliness may be associated with both their own and one another's behaviors. To examine the extent to which parent and child loneliness predict body mass index (BMI) and eating in parents and adolescents, an actor–partner interdependence model of loneliness, eating, and BMI in adolescent–parent dyads was analyzed. There were actor effects among adolescents such that greater loneliness was positively associated with emotional eating and BMI‐z, and there was an actor effect among parents such that higher loneliness was positively related to emotional eating. There was a partner effect among adolescents such that greater parental loneliness was positively associated with adolescent emotional eating, and there was a partner effect among parents such that higher adolescent loneliness was positively associated with parental emotional eating. There were several actor–partner effects for loneliness and junk food in dyads with boys. Findings highlight the importance of dyadic models of loneliness in adolescent–parent dyads.     

夜间进食综合征的研究进展

夜间进食综合征是一种表现为早晨没有食欲、晚饭后过量进食或夜间醒来进食的饮食障碍,并且与睡眠问题相关。在国内外文献进行分析研究的基础上,本文先后介绍了夜食症的概念内涵、发病的生理神经机制及主要的干预措施和治疗手段,并对现有研究的不足进行总结,提出了未来研究的方向,旨在为研究者在此领域的进一步探索提供参考。     

友谊质量与青少年直觉进食：链式中介模型及性别差异

基于积极心理学, 采用友谊质量量表、自我怜悯量表、身体欣赏量表和直觉进食量表, 对2438名初中生进行调查, 并运用结构方程模型探讨友谊质量与青少年直觉进食的关系、作用机制及其性别差异。结果表明：(1)友谊质量与直觉进食呈显著正相关; (2)自我怜悯和积极身体意象在友谊质量与直觉进食间起中介作用, 且该中介作用包含三条路径：自我怜悯的单独中介作用、积极身体意象的单独中介作用以及自我怜悯-积极身体意象的链式中介作用; (3)中介效应性别差异仅出现在友谊质量与直觉进食(分维度)的关系中, 即“无条件地允许进食”和“进食不受情绪影响”两个维度。研究结果为促进青少年形成积极身体意象、健康饮食行为提供了参考建议和干预指导。     

A closer look at the role of social influence in the development of attitudes to eating

The relationship between social influence and the development of attitudes to eating was explored in an experimental study. Schoolgirls (n=59, median age=15 years) listened to an interview in which the interviewee (identified as a radical feminist, a sportswoman or a women's magazine journalist) gave either a pro-diet or an anti-diet message. Following the interview, participants completed a questionnaire which examine their attitudes to eating and their judgements of the interviewee. The results supported predictions that influence would vary as an interactive function of the message and the normative ingroup–outgroup status of the message source. However, different patterns of influence were observed on two factors that emerged from an analysis of the eating disorder items, suggesting that there were important differences in the shaping of subjects' beliefs about appropriate eating behaviour, (a) for themselves personally and (b) for the community in general. The findings suggest that social influence has a significant but complex impact upon the development of potentially harmful attitudes to eating. It also appears that, for a variety of reasons, certain anti-diet messages may actually be a counter-productive means of improving female body satisfaction. © 1998 John Wiley & Sons, Ltd.     

Eating patterns and breakfast consumption in obese patients with binge eating disorder

This study examined eating patterns and breakfast consumption, and their relationships to weight and binge eating, in obese individuals with binge eating disorder (BED). One-hundred seventy-three consecutively evaluated men (n=46) and women (n=127) with BED were administered semi-structured interviews and self-report measures to assess the frequency of meals and snacks eaten, as well as binge eating and eating disorder features. Overall, those who consumed more frequent meals, particularly breakfast, and snacks, weighed less. Breakfast, which was eaten on a daily basis by less than half of participants (n=74; 43%), was the least frequently eaten meal of the day. Participants (n=56; 32%) who ate three meals per day weighed significantly less, and had significantly fewer binges, than participants (n=117; 68%) who did not regularly eat three meals per day. Thus, eating more frequently, having breakfast and consuming three meals every day, have potentially important clinical applications for the treatment of BED given that the effectiveness of specific interventions within treatments for BED are unknown, and that weight loss outcome for BED has been poor.     

Loss of control over eating in obese youngsters

OBJECTIVE: To investigate loss of control over eating in a sample of obese youngsters seeking treatment. METHOD: Obese youngsters (aged 10-16) were categorized into those having experienced loss of control (LC) and those who had not (NoLC) using the child version of the Eating Disorder Examination. Furthermore, the LC group was subdivided into an objective binge eating (OBE) and a subjective binge eating (SBE) group. The groups were compared on psychological measures. RESULTS: LC subjects (17.9%) showed more concern about eating, weight and shape. They also reported more emotional and external eating behaviors and more depression. Youngsters who report SBE show resemblances to both NoLC and OBE subjects. DISCUSSION: LC subjects are characterized by more eating-related psychopathology and higher levels of depression. Especially obese youngsters with OBE turned out to be a pathological group.     

Dysfunctional Eating in an Australian Community Sample: The Role of Emotion Regulation,Impulsivity, and Reward and Punishment Sensitivity

This study aimed to examine the role of emotion regulation and reinforcement sensitivity in dysfunctional eating behaviours. Two hundred twenty‐eight adults from the Australian community completed self‐report inventories assessing the variables. Dysfunctional restrained eaters differed from those who did not engage in restrained eating in terms of their emotion regulation, impulsivity, and sensitivity to reward. Difficulties in emotion regulation, low impulsivity, and sensitivity to reward predicted engagement in restrained eating. Emotional eaters significantly differed from those who did not engage in dysfunctional levels of emotional eating in terms of their emotion regulation, impulsivity, and sensitivity towards reward, and difficulties in emotion regulation predicted emotional eating. Finally, dysfunctional external eaters differed from non‐dysfunctional external eaters in terms of their emotion regulation, impulsivity, sensitivity towards reward, as well as sensitivity towards punishment, and difficulties with emotion regulation and sensitivity towards reward predicted external eating. These findings highlight the importance of the inclusion of emotional functioning in models of development and maintenance of eating disorders, and support the potential implementation of treatment interventions that address emotion regulation and include strategies to cope with impulsivity and reinforcement sensitivities.     

Evaluating Outcome Domains Assessing Caregivers of Individuals with Mental Illness: A Review

In this article, we describe the properties and consider the outcome dimensions of a collection of self‐administered questionnaires that assess caregivers of offspring with mental illness. To this end, we searched the MEDLINE, Web of Science, and PsycINFO databases, as well as reference lists of studies published between 1980 and 2012. We reviewed 43 instruments, and found multiple outcome domains, associated with either objective burden or subjective burden, or both. A number of tools captured additional negative aspects of caregiving (e.g., strain, stress, and worrying) as well as positive aspects (e.g., personal growth, strength, support, rewards, and satisfaction), supplemented by measures assessing caregivers' perceptions and attitudes toward their offspring with SMI (e.g., insight, stigma, and efficacy). This current review of existing measures and their specific domains contributes to a more comprehensive understanding of the caregiving experience and allows both clinicians and researchers to select the most appropriate measurement tools for their purposes.