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Objective: Sexual abuse is associated with eating disorders (EDs) severity. However, the psychological mediators of this association have received scant attention in the literature. Method: The present study aimed to evaluate the mediating role of psychological maladjustment, alexithymia, and self‐esteem in the relationship between sexual abuse and EDs severity in a sample of 134 treatment‐naïve patients with an EDs and 129 paired healthy controls. Results: In the EDs group, EDs severity among participants who had been sexually abused was mediated by greater psychological maladjustment and alexithymia (indirect effects: β = 12.55, 95% CI [6.11–19.87] p < 0.001; β = 3.22, 95% CI [0.235–7.97] p < 0.05, respectively). By contrast, these variables had no significant mediating effect on EDs severity in the control group. Discussion: These findings support the hypothesis of a disorder‐related relationship between sexual abuse and alexithymia and psychological maladjustment, which, in turn, influences EDs severity. Alexithymia and psychological maladjustment appear to be promising therapeutic targets for patients with EDs who have a history of sexual abuse. Highlights: Alexithymia and psychological maladjustment may mediate the relationship between sexual abuse and EDs severity in treatment‐naïve patients.Alexithymia and psychological maladjustment are promising therapeutic targets for patients with EDs and a history of sexual abuse. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to analyse the characteristics and the frequency of medical consultations in the year prior to the diagnosis and the intervention onset of the Eating Disorder, as well as the different prodromal symptoms. The final aim was to understand the origin of all referrals and their possible influence on the duration of untreated illness. Methods: We selected 99 young patients (15–25 years) and 61 healthy controls. Their primary and specialized care medical records were both studied retrospectively. Results: 87.6% of patients attended different consultations (primary care, specialized care and emergency department) the year prior compared to 67.2% of the controls (p =.002). The average number of consultations was 3.59 in the case group and 1.57 in the control group (p <.001). These consultations were related to prodromal symptoms in 57.4% compared to 16.4% for the controls (p <.001). They ranged from 29.8% of unspecific digestive symptoms, 22.8% of psychological symptoms, 19.3% of gynaecologic symptoms, 11.9% of weight variation, 8.8% of analytical changes, to 5.3% of malnutrition symptoms. Patients were mainly referred by Primary Care (42.7%). Overall, the mean of the Duration of Untreated Illness was of 7.45 months. Conclusions: The majority of reasons for consultation were related to symptoms that could be prodromal symptoms, but the patients were not diagnosed with an eating disorder. These findings highlight the importance of professionals understanding how to identify the warning signs of an eating disorder, so they can refer patients to a specialized unit to establish an early treatment. [ABSTRACT FROM AUTHOR]

Objective This study examined the longitudinal reciprocal associations between resilience factors, quality of life (QoL) domains, and symptoms of eating disorders (EDs). Hypotheses included predictive paths from resilience factors of “acceptance of self and life” and “personal competence” to increased QoL and predictive paths from previous levels of QoL to resilience. Method A total of 184 patients with EDs (mean age = 29.55, SD = 9.17, 94.8% women) completed measures of resilience, QoL, and EDs symptoms over three waves spaced six month apart. Hypotheses were tested by path analysis. Results Resilience factors predicted improvements in psychological health and social relationship domains of QoL and a reduction of ED symptoms over time. In addition, psychological health increased acceptance of self and life consistently over time, whereas physical health increased the competence component of resilience. Discussion The relationships between resilience factors and QoL are reciprocal, with several mediational paths. A spiral of recursive influences between resilience factors and QoL can take place in people with EDs. This possibility offers new perspectives to understanding the process of recovery in patients with ED. [ABSTRACT FROM AUTHOR]

Introduction. High comorbidity between borderline personality disorder (BPD) and eating disorders (ED) shows the necessity of developing transdiagnostic models, where impulsivity could play a relevant role in the manifestations of self-injurious behaviour. Objectives: 1) To compare the levels of impulsivity and self-injurious behaviour among people with BPD, people with ED and controls. 2) To predict the presence of self-injurious behaviour based on impulsivity and other relevant clinical variables, such as the experience of traumatic events and sensitivity to rejection. Methods. 108 women (23 controls; 29 with a diagnosis of restrictive ACT (rED); 21 with a diagnosis of purgative ACT (pED); and 35 with a diagnosis of BPD) were assessed using the Barratt Impulsivity Scale, the Traumatic Experiences Questionnaire and the Sensitivity to Rejection Questionnaire. Information about self-injurious behaviour was collected through interview and clinical history. Results. Differences in impulsivity and self-injurious behaviour scores were found between the groups, with higher impulsivity in the BPD and pED groups, and higher rates of self-injurious behaviour in the BPD group followed by both ED groups. On the other hand, impulsivity predicted suicide attempts, and together with sensitivity to interpersonal rejection predicted nonsuicidal self-harm (NSSH). Conclusion. Impulsivity is a dimensional variable in BPD and ED, which in turn plays a relevant role in the prediction of self-injurious behaviour. [ABSTRACT FROM AUTHOR]

To validate into Spanish the Wagnild and Young Resilience Scale -- 25 (RS-25), assess and compare the scores on the scale among women from the general population, eating disorder (ED) patients and recovered ED patients. Method This is a cross-sectional study. ED participants were invited to participate by their respective therapists. The sample from the general population was gathered via an open online survey. Participants (N general population=279; N ED patients=124; and N recovered ED patients=45) completed the RS-25, the World Health Organization Quality of Life Scale-BREF and the Hospital Anxiety and Depression Scale. Mean age of participants ranged from 28.87 to 30.42years old. Statistical analysis included a multi-group confirmatory factor analysis and ANOVA. Results The two-factor model of the RS-25 produced excellent fit indexes. Measurement invariance across samples was generally supported. The ANOVA found statistically significant differences in the RS-25 mean scores between the ED patients (Mean=103.13, SD=31.32) and the recovered ED participants (Mean=138.42, SD=22.26) and between the ED patients and the general population participants (Mean=136.63, SD=19.56). Discussion The Spanish version of the RS-25 is a psychometrically sound measurement tool in samples of ED patients. Resilience is lower in people diagnosed with ED than in recovered individuals and the general population. [ABSTRACT FROM AUTHOR]

Abstract: The aim of this study was to examine the psychometric properties of the Spanish version of the Eating Disorders Symptom Impact Scale (EDSIS-S), which is designed to evaluate an eating disorders-specific caregiving experience. A cross-sectional study was conducted among 187 Spanish caregivers of relatives with an eating disorder. Measures included the Experience of Caregiving Inventory (ECI) and General Health Questionnaire (GHQ-12). Socio-demographic variables of the carers and clinical variables of the patients were collected. Results supported the factorial structure, reliability and convergent validity of the instrument and the instrument was acceptable for assessing the eating disorders-specific experience of caregiving in Spain. Almost all of the factor loadings were >0.40. Cronbach’s alpha coefficients were mostly superior to 0.70. The EDSIS-S instrument has good psychometric properties and is similar to the original in terms of validity and reliability. Further examination of the factor structure of this instrument among adult samples is indicated. From a clinical perspective, the EDSIS allows for tailoring caregiver interventions to address the specific impact of symptoms on individual carers. [Copyright &y& Elsevier]

Eating disorders (ED) represent a group of very complex and serious diagnoses characterized by emotional dysregulation and impulsivity. New approaches are necessary to achieve effective diagnosis and treatments. Shifting biomarker research away from the constraints of diagnostic categories may effectively contribute to a dimensional differentiation across disorders according to neurobiology (e.g., inflammatory biomarkers). Thus, the aim of our study was to identify inflammatory profiles in patients with ED. A sample of 100 women with an ED (23.4 ± 8.55 years) and 59 healthy controls (HC) (20.22 ± 4.18 years) was used. K-means cluster analysis was followed to identify inflammatory clusters considering seven blood biomarkers (iNOS, TNFα, COX2, p38, ERK, TBARS and PPARγ). Moreover, a wide assessment of clinical features was conducted. Two distinct clusters were identified. Cluster 1 patients were characterized by higher inflammatory levels of TNF-α, COX2, p38, and ERK, and had more restrictive anorexia diagnosis than cluster 2. Cluster 2 participants showed higher inflammatory levels of iNOS and were older than cluster 1 and controls and had lower BMI than HC. In addition, they had higher levels of bulimic symptoms than those from the cluster 1 and HC, and higher impulsivity than HC. All ED patients (regardless of cluster) showed higher ED symptoms and more trauma than HC. Our study revealed that inflammatory dysfunction may be linked with clinical endophenotypes in ED, one more restrictive (cluster 1) with an inflammation/oxidative endophenotype more cytokine and MAPK/ERK mediated, and the other more impulsive, with more bulimic symptoms (cluster 2) with NO free radical high output source iNOS. Trauma seems to be a vulnerability factor for both endophenotypes. • We identified two different inflammatory groups among patients with eating disorders. • Inflammatory group 1 was characterized by higher levels of TNF-α, COX2, p38, and ERK. • Inflammatory group 1 also had more restrictive anorexia diagnosis. • Group 2 had higher levels of iNOS and showed more bulimic symptoms and impulsivity. • Both eating disorder groups experienced more traumatic events compared to controls. [ABSTRACT FROM AUTHOR]

Psychological and pharmacological treatments for eating disorder involve personal and health costs. In this paper we study the various reasons that may be associated to abandonment in both types of treatments in patients diagnosed with a disorder of eating behavior and the kind of neglect: neglect after evaluation, early and late abandonment. On the other hand, we analyze whether there is any relationship between the diagnosis and the type of abandonment. Various characteristics (age, sex, diagnosis, motives and types of neglect, and satisfaction with the unit eating disorder) in 212 patients treated at a specialized service in the treatment of eating disorder were examined during a period of two years. Our data support the hypothesis that the rate of abandonment of the most common treatments is delayed type, motivated by the improvement of the disorder of eating behavior, while no verified that there is some relationship between the diagnosis and the type of abandonment. Our results indicate that the reasons for dropping out are heterogeneous. You can set two different profiles of dropouts, one linked to improvement and to temporary disability, and other related to various reasons. [ABSTRACT FROM AUTHOR]

The objectives of the authors in this study were two-fold: (1) to explore the role of resilience in recovery from eating disorders (EDs), and (2) to develop a model of resilience in women with EDs. Semi-structured interviews with ten women were conducted in April 2011, along with two focus groups with women who had recovered from EDs (n = 5 women each; conducted in April 2012 at the University of Deusto, Spain), one focus group with clinical experts (n = 8; conducted in April 2012 at the Foundation Against EDs of Biskay, Spain), and six narratives from primary caregivers of ED patients living in Biskay, Spain (conducted in November 2012). All data were analyzed using a grounded theory approach. All female participants acknowledged experiencing resilience in their recovery. The analysis resulted in a conceptual model of resilience composed of the following categories: deep dissatisfaction with life, turning point, acceptance, hope, determination to change, accountability for the ED, active coping, getting social support, gaining self-knowledge, getting information about EDs, increase well-being, trait resilience, initiating new projects and living in the here and now. According to the model presented, resilience preceded the experience of recovery in women with EDs in this sample and could be a useful asset for future interventions. [ABSTRACT FROM PUBLISHER]

Objective: Altered cognitive functioning could have an important role in the development and maintenance of Anorexia Nervosa (AN). The majority of previous research has focused on flexibility and global-detail processing. The aim of this study was to explore planning abilities in women with AN.Method: Women with AN (n = 32) were compared to healthy controls (n = 42) using two different types of neuropsychological tasks for the assessment of planning abilities: Tower of London (ToL), a classic measure of planning abilities, and Zoo Map test, a more ecologically valid planning measure. Measures of AN psychopathology, anxiety, depression, and obsessive compulsivity were also collected.Results: The AN group did not differ from controls in the ToL (allp-valuesp > .05), although they performed significantly worse than controls in the main score of the Zoo Map (p = .02). A worse performance in the Zoo Map test More was associated with more eating disorders (rho = −.44,p = .018) and depressive (rho = −.42,p = .026) symptoms in the AN group.Conclusions: Our study suggests the presence of subtle planning difficulties in women with AN which might be better detected using tasks with increased ecological validity. [ABSTRACT FROM AUTHOR]

• Serum levels of IL-1β and IL-6 are significantly lower in eating disorder patients, particularly in males, compared with healthy controls. • Serum levels of IL-10 among ED patients are elevated, supporting the idea of an immunosuppressive status in the early stages of the disease. • Early onset patients without any previous treatment could remain in a reward-dependent state. Growing interest exists in the association of the immune system and its role in the development and maintenance of eating disorders (ED). Current evidence suggests that serum cytokine levels seem to be elevated in females with anorexia nervosa (AN). However, less is known in bulimia nervosa (BN) and other specified feeding and eating disorders (OSFED), specially in males. We aimed to perform a case-control study in a sample of forty eight young patients (38 females and 10 males) with early diagnosis of AN, BN or OSFED and without any previous treatment, compared with twenty nine healthy controls (19 females and 10 males) matched by age, sex and socioeconomic status. We evaluated eating-related psychopathology and depressive symptoms and measured serum concentration of proinflammatory cytokines IL-1β, IL-6, and TNF-α and anti-inflammatory cytokine IL-10. Contrary to expectations, levels of IL-1β and IL-6 were significantly lower in ED patients, compared with healthy controls. Comparing the different groups of females, we found elevated levels of IL-10 among ED patients therefore supporting the idea of an immunosuppressive status in the early stages. This could indicate that early onset patients without any previous treatment could remain in a reward-dependent state with a lower immune response. [ABSTRACT FROM AUTHOR]