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Objective: To examine the psychometric properties of the Parent Eating Disorder Examination Questionnaire (PEDE‐Q), developed to improve eating disorder (ED) assessment among youth by including parents as informants. Methods: A multi‐site, transdiagnostic sample of 355 adolescents with EDs completed the Eating Disorder Examination Questionnaire (EDE‐Q) and their parents completed the PEDE‐Q. Results: The internal consistencies of the PEDE‐Q subscales were on par with established EDE‐Q ranges (.73 to.90), both when examined using the original four‐factor EDE‐Q subscales and the seven‐item, three‐factor subscales of the brief EDE‐Q. Statistically significant medium‐ to large‐sized correlations and poor to moderate levels of agreement were found between the corresponding EDE‐Q and PEDE‐Q subscales. Receiver‐operator characteristic (ROC) curves showed that the PEDE‐Q had a statistically significant area under the curve (AUC) to maximize sensitivity and specificity in diagnosing full‐syndrome AN, whereas the EDE‐Q did not. Based on chi‐square analyses, the PEDE‐Q identified a statistically significantly greater number of AN cases than the EDE‐Q. The EDE‐Q yielded a BN diagnosis more frequently than the PEDE‐Q, although this difference was not statistically significant. Discussion: Results suggest that the PEDE‐Q has good psychometric properties and provides incremental information that can aid in the assessment and diagnosis of adolescents with EDs, particularly those with AN. Public significance: There exist complex challenges to identifying clinically significant eating disorders among youth. The PEDE‐Q is a questionnaire measure that improves eating disorder assessment among children and adolescents by asking parents to report on the symptoms and behaviors they have observed in their child and that youth may not fully disclose. The PEDE‐Q can aid in the diagnosis of adolescents with eating disorders, particularly those with anorexia nervosa. [ABSTRACT FROM AUTHOR]

Objectives: The current study was conducted to further understand the experiences of youths with an eating disorder with accessing services and receiving treatment. Participants' perceptions of the role of gender in eating disorder treatment was also assessed. Design: A prospective mixed methods design was used, with the current report focusing on qualitative interviews. Methods: Youths who were receiving services in a specialized paediatric eating disorder program completed a semi-structured interview in combination with a visual lifeline upon their discharge. A process of interpretative induction was employed to derive high-level concepts from the interviews. Results: A total of 28 youths (15 males and 13 females) completed an interview. Four high-level concepts were identified: (1) unwanted/non-collaborative support, (2) conflicting views, (3) dynamics in relationships (with subconcepts relating to peers and health professionals), and (4) changing mindset. Although many participants viewed treatment as universal, a subset of participants noted that treatment was tailored towards females. Conclusions: Youths shared several challenges that they encountered in their journey to accessing specialized eating disorders treatment, including disagreement with their parents/caregivers and health professionals about treatment plans. Interactions with peers and health professionals represented both a facilitator (e.g., feeling supported and inspired by peers) and a challenge (e.g., negative interactions with professionals). Some youths shared concerns about the female-centric nature of treatment. The results of this study highlight the importance of collaborative care for paediatric eating disorders, and consideration for gender inclusivity in eating disorders treatment. [ABSTRACT FROM AUTHOR]

Certain presentations of Avoidant/Restrictive Food Intake Disorder (ARFID) and Somatic Symptom and Related Disorders (SSRDs) have conceptual overlap, namely, distress and impairment related to a physical symptom. This study compared characteristics of pediatric patients diagnosed with ARFID to those with gastrointestinal (GI)-related SSRD. A 5-year retrospective chart review at a tertiary care pediatric hospital comparing assessment data of patients with a diagnosis of ARFID (n = 62; 69% girls, M age = 14.08 years) or a GI-related SSRD (n = 37; 68% girls, M age = 14.25 years). Patients diagnosed with ARFID had a significantly lower percentage of median BMI than those with GI-related SSRD. Patients diagnosed with ARFID were most often assessed in the Eating Disorders Program, whereas patients diagnosed with an SSRD were most often assessed by Consultation-Liaison Psychiatry. Groups did not differ on demographics, psychiatric diagnoses, illness duration, or pre-assessment services/medications. GI symptoms were common across groups. Patients diagnosed with an SSRD had more co-occurring medical diagnoses. A subset (16%) of patients reported symptoms consistent with both diagnoses. Overlap is observed in the clinical presentation of pediatric patients diagnosed with ARFID or GI-related SSRD. Some group differences emerged, including anthropometric measurements and co-occurring medical conditions. Findings may inform diagnostic classification and treatment approach. [ABSTRACT FROM AUTHOR]

Objective: The current study explored the experience and familiarity of pediatric health professionals with avoidant/restrictive food intake disorder (ARFID), and assessed the application of diagnostic criteria in a series of clinical vignettes. Method: Pediatric health professionals were invited to complete an online survey. Data from 93 health professionals from medical and allied health roles who completed the survey were analyzed. Results: Respondents providing care for pediatric feeding/eating disorders were more likely to report familiarity with ARFID than those not typically providing care for feeding/eating disorders. Clinicians who had provided care for pediatric ARFID reported more confidence in clinical management of ARFID than did those who had not yet provided care for ARFID, though there were overall relatively low levels of confidence in providing care for ARFID. Respondents to the clinical vignettes were more likely to confer a diagnosis of ARFID when there were symptoms of both psychosocial impairment and weight loss than when there was psychosocial impairment alone. Discussion: The results suggest variability in current application of diagnostic criteria for ARFID, low confidence in clinical management of ARFID, and ambiguity in clinicians' judgments regarding whether psychosocial impairment is sufficient to meet a diagnosis of ARFID. [ABSTRACT FROM AUTHOR]

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Objective: Related to the cognitive‐behavioral theory of eating disorders, body checking has gained increasing recognition as both a maintaining factor for eating disorders and an important target for treatment. However, it is unclear whether body‐checking behaviors contribute to the development of disordered eating, or if these behaviors develop as a response to experiencing eating disorder thoughts and behaviors. This study aims to examine the relationships between body‐checking behaviors and eating disordered thoughts and behaviors in adolescent females and males in the community over time. Methods: Participants included 238 adolescents (n = 104 males, n = 134 females, Mage= 16.5 years) recruited from high schools in British Columbia, Canada, who completed the Eating Disorder Examination Questionnaire and Body Checking Questionnaire at baseline (T1) and again approximately 4 months later (T2). Results: After controlling for baseline levels of eating pathology and body mass index (BMI), body checking at T1 predicted increases in eating pathology for both males and females. In contrast, after controlling for baseline levels of body checking and BMI, eating pathology at T1 did not predict changes in body checking for females, but it did for males. Findings suggest that, among adolescents, engaging in body‐checking behaviors may increase risk for disordered eating. Discussion: If supported by further research, targeting body‐checking behaviors in prevention programs may be warranted. [ABSTRACT FROM AUTHOR]

Research in adults demonstrates a positive association among obsessive–compulsive symptoms, eating pathology, cognitive distortions, and comorbid depressive symptoms. Given that adolescence is characterized by unique and rapid changes in biopsychosocial processes, it is imperative to elucidate the relationship between these variables in youth. In this cross-sectional study, we explored whether obsessive–compulsive symptoms, thought–action fusion, thought–shape fusion, and eating pathology would be positively associated with and predict depressive symptoms in a school-based community sample of adolescents (n = 86; M age = 15.60). All study variables were positively correlated with depressive symptoms. Results indicated that obsessive–compulsive symptoms, thought–shape fusion, and eating pathology explained a significant proportion of variance in depressive symptoms, whereas thought–action fusion did not. In accordance with the cognitive behavioral model of psychopathology, these findings highlight the relationships between key interrelated correlates of depressive symptoms that may be pertinent targets for prevention and treatment efforts in adolescents. [ABSTRACT FROM AUTHOR]

Objective: A wealth of evidence indicates that self‐compassion is linked with positive psychological outcomes; however, little is known about the process through which self‐compassion exerts its effect. The primary purpose of this research was to investigate the direct and indirect impact of self‐compassion on body satisfaction and eating pathology in adolescents. Method: Two hundred and thirty‐eight students were recruited from three local high schools (Mage = 16.49, 43.7% boys). All participants completed the Self‐Compassion Scale (SCS), Hopkins Symptom Checklist (SCL‐5), Body Areas Satisfaction Scale (BASS), and Eating Disorder Examination Questionnaire ‐ Adolescent Version (EDE‐Q) at baseline. The SCL‐5, BASS, and EDE‐Q were completed 4 months later. Results: Self‐compassion was positively associated with body satisfaction and negatively associated with psychological distress and eating pathology in boys and girls at both time points. Longitudinal conditional process analyses revealed that self‐compassion predicted changes in body satisfaction and eating pathology through changes in psychological distress for girls only. Notably, self‐compassion was higher in boys than in girls. Discussion: Results underscore how self‐compassion may be an important factor to target in fostering a positive body image and preventing disordered eating in adolescents. [ABSTRACT FROM AUTHOR]

Thought–shape fusion (TSF) describes the experience of marked concerns about body weight/shape, feelings of fatness, the perception of weight gain, and the impression of moral wrongdoing after thinking about eating fattening/forbidden foods. This study sets out to evaluate the short version of the TSF trait questionnaire (TSF). The sample consists of 315 healthy control women, 244 women with clinical and subthreshold eating disorders, and 113 women with mixed mental disorders (mixed). The factor structure of the TSF questionnaire was examined using exploratory and subsequent confirmatory factor analyses. The questionnaire distinguishes between a Concept scale and a Clinical Impact scale. However, a lack of measurement invariances refers to significant differences between groups in terms of factor loadings, thresholds, and residuals, which questions cross‐group validity. Results indicate that the concept is understood differently in the 3 groups and refers to the suitability of the questionnaire primarily for individuals presenting with symptoms of eating disorders. [ABSTRACT FROM AUTHOR]

A retrospective chart review was conducted to elucidate the clinical and medical characteristics of male youth admitted to a tertiary inpatient treatment center for eating disorders. A total of 23 male youth were identified who had received treatment between January 2003 and February 2014, and for whom charts were available. The majority of the sample (n= 19; 82.6%) received a diagnosis of anorexia nervosa, and the data suggest that these male youth were significantly medically compromised. The patterns in this data will be discussed in the context of previous published research on male youth with eating disorders. [ABSTRACT FROM PUBLISHER]

Background: Thought-Shape Fusion (TSF) and Thought-Action Fusion (TAF) are cognitive distortions that are associated with eating and obsessional pathology respectively. Both involve the underlying belief that mere thoughts and mental images can lead to negative outcomes. TSF involves the belief that food-related thoughts lead to weight gain, body dissatisfaction, and perceptions of moral wrong-doing. TAF is more general, and involves the belief that merely thinking about a negative event (e.g., a loved one getting into a car accident) can make this event more likely to happen, and leads to perceptions of moral wrong-doing. However, the shared susceptibility across related cognitive distortions-TAF and TSF-has not yet been studied. Method: The effects of TSF and TAF inductions in women with an eating disorder (n = 21) and a group of healthy control women with no history of an eating disorder (n = 23) were measured. A repeated-measures design was employed, with all participants exposed to a TSF, TAF and neutral induction during three separate experimental sessions. Participants' cognitive and behavioral responses were assessed. Results: Individuals with eating disorders were more susceptible to TSF and TAF than were control participants, demonstrating more neutralization behavior after TSF and TAF inductions (i.e., actions to try to reduce the negative effects of the induction), and reporting higher levels of trait TAF and TSF than did controls. Conclusions: Individuals with eating disorders are particularly susceptible to both TAF and TSF. Clinical implications of these findings will be discussed. [ABSTRACT FROM AUTHOR]

Degree of ego-dystonicity in obsessions is clinically relevant to the conceptualization and treatment of eating disorders (EDs). Obsessive-compulsive disorder research has suggested that the transformation of intrusive thoughts into obsessions is linked to the degree to which intrusive thoughts threaten core perceptions of the self. This study aims to explore the relationship between the ego-dystonic nature of obsessions in ED patients and a fear of self, the link between ED symptom severity and ego-dystonicity in obsessions, and differences between non-clinical and individuals with EDs in the presence of ego-dystonic thoughts and a fear of self. Ego-dystonicity (Ego-dystonicity Questionnaire (EDQ)) and feared self (Fear of Self Questionnaire (FSQ)) degrees were measured in a clinical sample ( n = 57 with EDs) and a non-clinical sample ( n = 45). EDQ and FSQ scores were highly correlated in both samples. EDQ scores were not significantly correlated to ED symptom severity with the exception of the EDQ Irrationality subscale, which was strongly related to compulsion severity. Participants with an ED had significantly higher EDQ and FSQ scores compared with controls. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]