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Research on adolescent bariatric surgery candidates is limited by insufficient inclusion of ethnic minorities and males, and lack of consideration of the full spectrum of disordered eating behaviors (i.e., restriction, compensatory behaviors [e.g., purging], overeating/binge eating behaviors). The current study investigated differences in the full range of disordered eating behaviors across sex and ethnicity among adolescents seeking bariatric surgery. Teaching hospital, United States. Data were collected using retrospective chart review of 79 adolescent bariatric surgery candidates (59% female, 46.8% Hispanic, MBMI = 50.2, SDBMI = 10.0, Mage = 17.3, SDage = 2.02) who had completed the self-reported Eating Disorder Diagnostic Scale for DSM-5 at intake. Approximately 33% of study participants met self-reported criteria for an eating disorder, with 35% endorsing binge eating behaviors and 50% endorsing compensatory behaviors. Few differences in behavior frequencies were observed across sex or racial/ethnic status. Findings underscore the importance of assessing the full spectrum of disordered eating behaviors among adolescent bariatric surgery candidates.

Objective This study explored treatment experiences and social support among individuals with eating disorders (EDs) in mainland China. Method Subscribers of a Chinese online social media platform (WeChat) focused on EDs were invited to complete a screening questionnaire that included the Eating Disorder Diagnostic Scale for the DSM-5. Of the 116 questionnaire responses, 31 met inclusion criteria for follow-up interviews. Individuals who never sought treatment were not eligible for follow-up interviews, but provided brief explanations about why they did not seek treatment. All eligible participants (n = 31) completed a semi-structured interview about their experiences with ED treatment and social support. Qualitative data from the interviews and survey responses regarding not seeking treatment were subjected to inductive data-driven thematic analysis with deductive coding to illuminate treatment and social support experiences or reasons for not seeking treatment. Results Themes emerged from interviews revealed positive inpatient treatment experiences for anorexia nervosa, but negative outpatient treatment experiences, unaffordable care, and ineffective psychopharmacological treatments. Parents, friends, and partners were sources of social support, but participants largely felt misunderstood or blamed by these same entities. Shame, not recognizing ED as an illness, and financial constraints were listed as the primary reasons for not seeking treatment. Discussion The importance of hearing patients' perspectives, improving ED literacy in China, increasing knowledge of culturally specific manifestations of EDs, and developing culturally responsive services and dissemination of treatment resources are emphasized.

Objective Despite a growing literature on potential risk factors for eating disorders, longitudinal research starting before adolescence is scarce, and little is known about risk factors in males. We investigated risk factors in preadolescent boys and girls for the development of eating pathology in adolescence and young adulthood.Method This study is part of TRAILS (TRacking Adolescents' Individual Lives Survey), a Dutch population-based cohort study (N = 2,229) from preadolescence into adulthood. Potential risk factors were measured at age 11, based on self-report, reports of one of the parents, and records of the Preventive Child Healthcare. Variables included sociodemographic variables, pregnancy and perinatal factors, eating- and weight-related factors, psychological functioning, stressful experiences and family factors. At age 19, two-stage screening including interviews by eating disorder experts was used to examine the prevalence of eating disorders. At age 22 and 26, eating pathology was assessed by the Eating Disorder Diagnostic Scale.Results Preadolescent anxious distress and high weight were associated with eating pathology in adolescence and young adulthood in both boys and girls. Overeating in preadolescence was found to be a prodromal symptom of eating disorders during late adolescence. No evidence was found for sex-specific risk factors.Discussion Anxious preadolescents with high weight are at increased risk for the development of eating pathology later on. Clinicians should be aware of eating disorder symptoms - like overeating - in this high-risk group of children, and could consider an early intervention to prevent the development of full-blown eating disorders.

Objective: The aim of this study was to systematically review the methodologies used for BE evaluation/identification diagnosis in clinical trials (CT) with adults. Methods: The search was performed on PUBMED until July 2018. The PRISMA statement was used to improve the reporting of results.Results: 93 CTs were included among the 225 studies retrieved. The main BE evaluation/identification methods used in studies were: Binge Eating Scale; Diagnostic and Statistical Manual of Mental Disorders; Eating Disorder Diagnostic Scale; Eating Disorder Examination; Eating Disorder Examination Questionnaire; Eating Disorder Inventory; Loss of Control Over Eating Scale and Three-Factor Eating Questionnaire. Overlaps between methods were observed in studies, 61 used both DSM and an evaluation instrument, 06 only DSM and 26 only standardized questionnaires to assess BE disorder. Conclusions: The DSM-5 diagnostic criterion for binge eating disorder is considered excellent and widely used, however, when the objective of the study is to identify emotional, nutritional and qualitative issues, a questionnaire or interview about subjective perceptions can be used in a complementary way. Objetivo: O objetivo deste estudo foi revisar sistematicamente as metodologias utilizadas para avaliação/identificação da compulsão alimentar em ensaios clínicos com pacientes adultos. Métodos: A busca foi realizada no PUBMED até julho de 2018. Foi utilizado o protocolo PRISMA para reportar os resultados. Resultados: Foram incluídos 93 ensaios clínicos dentre os 225 que foram encontrados na busca da literatura. Os principais métodos de avaliação / identificação da compulsão alimentar utilizados nos estudos foram: Binge Eating Scale; Manual Diagnóstico e Estatístico de Transtornos Mentais; Escala de Diagnóstico de Transtorno Alimentar; Exame de Transtorno Alimentar; Questionário de Exame de Transtorno Alimentar; Inventário de Desordens Alimentares; Escala de Perda de Controle sobre a Alimentação e Questionário de Alimentação de Três Fatores. Foram observadas sobreposições entre os métodos nos estudos, 61 utilizaram o DSM e outro instrumento de avaliação, seis estudos utilizaram apenas o DSM e 26 apenas questionários padronizados para avaliar o transtorno de compulsão alimentar. Conclusão: O critério diagnóstico do DSM-5 para o transtorno de compulsão alimentar é considerado excelente e utilizado amplamente, entretanto, quando o objetivo do estudo é identificar questões emocionais, nutricionais e qualitativas, pode ser utilizado de forma complementar um questionário ou entrevista sobre percepções subjetivas.

Teenage phase is a critical period of psychosocial development. Adolescent eating patterns are formed in this phase. Household food security is among factors which may infl uence eating pattern. Adolescent who are exposed to food insecure condition tend to experience stress, which one of the coping mechanisms is overeating and may develop binge eating disorder. The purpose of this study is to analyze association between household food security status and binge eating disorder in adolescent. This case control study in volved 74 adolescents aged 16-18 years and their parents in Semampir District, Surabaya, Indonesia who were selected ran domly using simple random sampling. Household food security was assessed by using the Household Food Insecuri ty Access Scale (HFIAS) and binge eating disorder is assessed by using Eating Disorder Diagnostic Scale (EDDS). T he association between household food security and binge eating disorder was analyzed by Spearman’s correlation te st. There was an association between food security status (p = 0,001) and binge eating disorder. Further analysis showed that adolescents at risk of food insecurity were 5,625 times more likely to experience a binge eating disorder. This study recommends to increase food security through economic empowerment of housewives and socialization about copi ng strategy for both parent and adolescent.

Studies on eating disorders among Jordanian adolescents have reported variable prevalence rates of 12-40%.This study aimed to determine the prevalence of eating disorders among Jordanian adolescents with and without dysglycaemia and determine the associated factors.A comparative cross-sectional study was conducted during the period November 2017-February 2018. The Eating Disorder Diagnostic Scale was used to assess the presence of different types of eating disorders, including anorexia nervosa, bulimia nervosa and binge eating disorder. A typical anorexia nervosa and purging disorder were considered "other eating disorders" in this study.This study included 497 patients with dysglycaemia and 504 age-matched nondysglycaemic participants. Patients with dysglycaemia had a significantly higher prevalence of binge eating disorders compared with nondysglycaemic participants (11.9% vs 5.8%, P0.001). In dysglycaemia group, adolescents who were aged ≥ 14 years were more likely to have bulimia nervosa compared with those14 years old. Patients with a sedentary lifestyle were less likely to have bulimia nervosa and binge eating disorders. In the nondysglycaemic group, those aged 14-18 years were more likely to have other eating disorders. Those with dysglycaemia were more likely to have binge eating disorders than those in the nondysglycaemic group (OR = 2.1, 95% CI: 1.3-3.3; P = 0.002) after adjusting for possible confounders.Adolescents with dysglycaemia had higher prevalence of eating disorders compared with their nondysglycaemic peers. Screening for eating disorders is recommended among adolescents to secure early detection and subsequent intervention.اضطرابات الأكل بين المراهقين الأردنيين المصابين بخلل سكر الدم وغير المصابين به: دراسة مقارنة.هدى الحوراني، رنا أبابنة، نهلة خواجة، يوسف خضر، كامل العجلوني.أفادت الدراسات التي أُجريت على اضطرابات الأكل بين المراهقين الأردنيين أن معدلات الانتشار المتغيرة تتراوح بين 12–٪40.هدفت هذه الدراسة إلى تحديد معدل انتشار اضطرابات الأكل بين المراهقين الأردنيين المصابين بخلل سكر الدم وغير المصابين به، وتحديد العوامل المرتبطة بذلك.أُجريت دراسة مقطعية مقارنة خلال الفترة من نوفمبر/تشرين الثاني 2017 إلى فبراير/شباط 2018. واستُخدِم مقياس تشخيص اضطرابات الأكل لتقييم وجود أنواع مختلفة من اضطرابات الأكل، بما فيها فقدان الشهية العصبي، والنهام العصبي، واضطراب نهم الطعام. وأخذت الدراسة بعين الاعتبار فقدان الشهية العصبي غير النمطي والاضطراب المُسهِل "اضطرابات الأكل الأخرى".شملت هذه الدراسة 497 مريضاً يعانون من خلل سكر الدم و 504 مشاركين من العمر نفسه لا يعانون من خلل سكر الدم. وكان معدل انتشار اضطراب نهم الطعام لدى المرضى المصابين بخلل سكر الدم أعلى بكثير مقارنةً بالمشاركين غير المصابين بخلل سكر الدم (0.001P ,٪5.8 vs٪11.9). وفي مجموعة المصابين بخلل سكر الدم، كان المراهقون الذين بلغت أعمارهم ≥ 14 سنة أكثر عُرضة للإصابة بالنهام العصبي مقارنةً بالذين تقل أعمارهم عن 14 سنة. وكان المرضى الذين يتَّبعون نمط حياة يتسم بقلة الحركة أقل عرضة للإصابة بالنهام العصبي واضطراب نهم الطعام. وفي مجموعة غير المصابين بخلل سكر الدم، كان أولئك الذين تتراوح أعمارهم بين 14–18 سنة أكثر عُرضة للإصابة باضطرابات الأكل الأخرى. وكان أولئك الذين يعانون من خلل سكر الدم أكثر عُرضة للإصابة باضطراب نهم الطعام من أولئك الذين ينتمون إلى مجموعة غير المصابين بخلل سكر الدم (0.002=p ;3.3-1.3=CI ٪95 ;2.1=OR) بعد التصحيح من أجل السيطرة على عوامل الإرباك المحتملة.كان معدل انتشار اضطرابات الأكل لدى المراهقين المصابين بخلل سكر الدم أعلى مقارنةً بأقرانهم الذين لا يعانون من خلل سكر الدم. ويوصَ بفحص المراهقين للتحرِّي عن اضطرابات الأكل لضمان الكشف المبكر والتدخل اللاحق.Étude comparative sur les troubles alimentaires chez les adolescents jordaniens avec et sans dysglycémie.Des études sur les troubles alimentaires chez les adolescents jordaniens ont fait état de taux de prévalence variables compris entre 12 et 40 %.La présente étude visait à déterminer la prévalence des troubles alimentaires chez les adolescents jordaniens avec et sans dysglycémie et à déterminer les facteurs qui y sont associés.Une étude transversale comparative a été menée au cours de la période allant de novembre 2017 à février 2018. L'échelle de diagnostic des troubles alimentaires a été utilisée pour évaluer la présence de différents types de troubles alimentaires, notamment l'anorexie mentale, la boulimie et l’hyperphagie boulimique. L'anorexie nerveuse atypique et le trouble de purge ont été considérés en tant « qu’autres troubles alimentaires » dans cette étude.Cette étude portait sur 497 patients atteints de dysglycémie et 504 participants sans dysglycémie appariés selon l'âge. Les patients atteints de dysglycémie présentaient une prévalence significativement plus élevée de troubles de la boulimie par rapport aux participants sans dysglycémie (11,9 % contre 5,8 %, p0,001). Les adolescents atteints de dysglycémie âgés de 14 ans ou plus étaient plus susceptibles de souffrir de boulimie nerveuse que ceux de moins de 14 ans. Les patients ayant un mode de vie sédentaire étaient moins susceptibles de souffrir de boulimie et d’hyperphagie boulimique. Dans le groupe des sujets non dysglycémiques, la probabilité d'avoir d'autres troubles alimentaires était plus élevée ceux âgés de 14 à 18 ans. Les participants atteints de dysglycémie étaient plus susceptibles d'avoir une hyperphagie boulimique que ceux du groupe non dysglycémique (OR = 2,1, IC à 95 % : 1,3-3,3 ; p = 0,002) après ajustement en fonction des facteurs de confusion possibles.Les adolescents atteints de dysglycémie présentaient une prévalence plus élevée de troubles alimentaires par rapport à leurs pairs non atteints de dysglycémie. Le dépistage des troubles alimentaires est recommandé chez les adolescents afin d'assurer une détection précoce et une intervention ultérieure.

OBJECTIVE: Eating disorder (ED) symptoms are common and impairing in males, despite their perception as “female” disorders. As existing self-report symptom measures were developed and primarily validated in women, there is a need to establish the utility of these measures in men. The present study used differential item functioning (DIF) analyses to explore whether item endorsement differed by gender for three commonly used ED symptom measures. METHOD: Participants were undergraduate men (n = 1,083) and women (n = 2,424) from three universities in the United States. Global scores on the Eating Attitudes Test-26 (EAT-26), Eating Disorder Examination Questionnaire (EDEQ), and Eating Disorder Diagnostic Scale for DSM-IV (EDDS) were examined. Tests of DIF were conducted by regressing each item against its composite scale score, and then comparing fit and variance explained (R(2)) to a model with the interaction of item*gender. The clinical significance threshold for DIF is ΔR(2) ≥ 0.13. RESULTS: There was no evidence of clinically significant DIF within the EAT-26, EDEQ, or EDDS. DISCUSSION: Findings suggest that the examined measures perform similarly for undergraduate men and women, supporting their use in nonclinical male samples. However, development and testing of items reflecting ED symptoms that more commonly occur in males (e.g., muscularity-oriented behaviors) is encouraged.

While previous literature suggests that emotion dysregulation is a salient factor contributing to the onset and maintenance of eating disorders (EDs), less is known about how maladaptive, cognitively oriented regulation strategies such as rumination and thought suppression may be uniquely related to ED symptoms in men and women. The present study sought to examine the independent associations of ruminative brooding and thought suppression with ED symptoms, after controlling for negative affect intensity, and assess whether these associations differ by gender. Participants were 263 undergraduates who completed a series of questionnaires, including measures of ED symptoms (Eating Disorder Diagnostic Scale), ruminative brooding (Ruminative Response Scale), and thought suppression (White Bear Suppression Inventory). Generalized linear models examined main effects of ruminative brooding and thought suppression and their interactions with gender on ED symptoms, controlling for negative affect intensity. Higher ruminative brooding was associated with higher binge eating among women. Thought suppression was associated with higher vomiting and fasting frequency in both genders, with a stronger association between suppression and fasting in men compared to women. Together results demonstrate the unique contributions of cognitive perseveration and avoidance in ED symptomatology; specifically, ruminative brooding may be a salient factor contributing to binge eating in women, while high levels of thought suppression among males may contribute to fasting. Findings highlight the potential importance of examining and differentially targeting specific facets of cognitive emotion regulation in men and women engaging in ED behaviors.

Objective This study tested the association between food insecurity and eating disorder (ED) pathology, including probable ED diagnosis, among two cohorts of university students before and during the beginning of the COVID‐19 pandemic. Method Students (n = 579) from a large Midwestern American university completed self‐report questionnaires assessing frequency of ED behaviors, ED‐related impairment, and individual food insecurity as measured by the Eating Disorder Diagnostic Scale 5, Clinical Impairment Assessment, and Radimer/Cornell, respectively. Chi‐square tests and MANOVA with post‐hoc corrections were conducted to compare demographic characteristics, ED pathology, and probable ED diagnosis prevalence between students with and without individual food insecurity. Results Partially supporting hypotheses, MANOVA indicated significantly greater frequency of objective binge eating, compensatory fasting, and ED‐related impairment for students with food insecurity compared with individuals without food insecurity. Chi‐squared tests showed higher prevalence of ED diagnoses among individuals with food insecurity compared with those without food security (47.6 vs. 31.1%, respectively, p

Individuals with high shape/weight concern (SWC) place disproportionate emphasis on shape and weight in evaluating their self-worth, making them more vulnerable to body-related cues. Binge eaters (BE), who are obsessed with devouring high-calorie foods, would show severe symptomatology, especially when they have clinically high SWC. The present study attempted to elucidate how SWC influences binging based on attentional patterns toward high-calorie food cues. A total of 120 participants were selected and divided into four groups: (1) BE with high SWC, (2) BE with low SWC, (3) healthy controls (HC) with high SWC, and (4) HC with low SWC. BE and SWC status were respectively determined using the Eating Disorder Diagnostic Scale (DSM-5) and the Eating Disorder Examination Questionnaire. All participants completed the same free-viewing task, measuring initial fixation latency and total fixation duration. BE with high SWC showed attentional bias toward high-calorie food cues in terms of significantly faster initial fixation latency and longer total fixation duration, whereas BE with low SWC and the HC groups did not show any differences. The results revealed that SWC level makes unique contributions to BE's initial orienting bias toward and difficulty disengaging from high-calorie food cues. This may indicate that BE with high SWC merely worry about eating high-calorie food in a cognitive way, but not controlling actual binging behavior. The current study of attentional bias elucidated the role of SWC as a potential maintenance factor of being concerned and binging in BE.

PURPOSE: Adherence to treatment is of great importance in patients with diabetes mellitus due to its necessity and benefits. The purpose of this study was to evaluate the relationship between personality disorder, depression and eating disorder with appropriate treatment acceptance and follow-up in patients with type 2 diabetes. METHODS: This cross-sectional study was performed in Imam Ali Medical Education Center in Karaj city of Alborz province of Iran. A total of 1320 patients were evaluated and were screened according to the inclusion criteria, including type 2 diabetes and those over 18 years of age. Finally, considering the exclusion criteria, 600 patients with type 2 diabetes were included in the study. Patients were divided into 4 groups. 150 patients with type 2 diabetes in the control group, 150 patients with type 2 diabetes with major depressive disorder, 150 patients with type 2 diabetes with personality disorder and 150 patients with type 2 diabetes and eating disorder were studied. Questionnaires used in the study included Hamilton Depression Rating Scale(HAM-D) for depression, Minnesota Multiphasic Personality Inventory II (MMPI II) questionnaire for personality disorders and Eating Disorder Diagnostic Scale(EDDS) for eating disorder. The Murisky questionnaire also assessed adherence to treatment in patients, which included 8 questions. Scores measure the degree of adherence to treatment. RESULTS: 600 patients with type 2 diabetes were studied. Patients were divided into 4 groups (each group consisting of 150 patients) of control, depression, personality disorder and eating disorder. Mean age, sex, marital status and duration of diabetes were not significantly different in the study groups (P > 0.05). The mean Murisky score in patients with depression and personality disorder was significantly lower than the control group (P < 0.05) but the mean Murisky score in patients with eating disorder was not significantly different (P > 0.05). Patients with depression, paranoid, schizotypal, antisocial, borderline, avoidant and dependent personality disorder had less adherent to treatment than the control group. CONCLUSIONS: Early psychiatric evaluation of patients with diabetes and identification of possible disorders can help improve diabetes control.

Background Eating disorders (EDs) have been shown to negatively impact occupational functioning and may be associated with employment status. Findings have been inconsistent, and depression may mediate this relation. Further, prior research focuses mainly on binge eating disorder's (BED) impact on occupational functioning. We assessed the association between transdiagnostic ED symptoms and occupational functioning and employment status among female veterans, who tend to have high rates of EDs and unemployment but who remain understudied. Method Participants were 198 female veterans (Mage = 54.09) in the New England region who participated in a larger study. They completed a mailed survey including the Eating Disorder Diagnostic Scale, Center for Epidemiologic Studies-Depression Scale, employment status (employed vs. unemployed and out of the workforce), and the Inventory of Psychosocial Functioning to assess occupational functioning. Results ED symptoms were not significantly related to employment status but were negatively associated with occupational functioning when controlling for body mass index. Depressive symptoms mediated the associations between ED symptoms and both being out of the workforce and occupational functioning, respectively. Discussion Higher levels of ED symptoms were associated with worse occupational functioning in a female veteran sample. Further, comorbid depressive symptoms may be an important treatment target when addressing occupational health in women experiencing ED symptoms.

OBJECTIVE Our aim was to evaluate the relationship between evening chronotype, a proxy marker of circadian system dysfunction, and disordered eating behavior and poor dietary habits in individuals with bipolar disorder (BD). METHODS In this cross-sectional study, we evaluated 783 adults with BD. Chronotype was determined using item 5 from the reduced Morningness-Eveningness Questionnaire. The Eating Disorder Diagnostic Scale (EDDS) and the Rapid Eating Assessment for Participants-Shortened Version (REAP-S) were used to assess disordered eating behavior and dietary habits respectively. General linear models and logistic regression models were utilized to evaluate differences between chronotype groups. RESULTS Two hundred and eight (27%) BD participants self-identified as having evening chronotypes. Compared to non-evening types, evening types were younger (P

This chapter provides an overview of binge eating assessments that are commonly used for diagnosis, case conceptualization, treatment planning, ongoing assessment, and treatment outcome. Included is a review of well-validated clinical interviews, self-report measures, and laboratory eating paradigms that are available for the assessment of binge-eating disorder (BED) in clinical and research contexts. Assessments with adequate psychometric properties are described, and benefits, limitations, and criteria assessed to aid in the selection of an appropriate measure for each context and question. This chapter describes disorders characterized by binge eating based on DSM-5 criteria and relevant updates from ICD-11. A review of clinical interviews including the Eating Disorder Examination (EDE), Eating Disorder Assessment for DSM-5 (EDA-5), and the Structured Clinical Interview for DSM-5 (SCID-5) are provided along with evaluations of self-report measures including the Eating Disorder Examination-Questionnaire (EDE-Q), the Eating Disorder Diagnostic Scale (EDDS), the Eating Pathology Symptoms Inventory (EPSI), Questionnaire on Eating and Weight Patterns (QWEP), and self-monitoring completed within the context of cognitive-behavioral therapy. Finally, laboratory eating paradigms are discussed as a useful and objective real-time assessment of eating behavior. In sum, this chapter provides information that may assist clinicians and researchers in understanding and selecting appropriate measures to evaluate binge eating.

The objective of this study was to explore the mediating effects of emotional eating, restrained eating, and external eating on the relationship between acculturation and binge eating among Latino adolescents. Adolescents who self-identified as Latino (N = 285) at public high schools in Southern California were recruited and completed a self-report survey. Acculturation was assessed using the 8-item Acculturation, Habits, Interests for Multicultural Adolescents (AHIMSA) scale for adolescents, mediators were assessed using Dutch Eating Behavior Questionnaire (DEBQ), and binge eating was assessed using a 13-item Eating Disorder Diagnostic Scale. A bootstrapped multiple mediation model was used to test mediation pathways. Findings suggest that individually each eating style—emotional, restrained and external eating pathway did not reach significance singly, but that jointly, their combined effect was significant with a total indirect effect (B = 0.15, CI 0.01-0.30) indicating an additive effect of the three eating styles. Future research should examine additional mediators of the relationship between acculturation and binge eating.

OBJECTIVE: Self-esteem is implied as a factor in the development of eating disorders. In adolescence peers have an increasing influence. Support for the role of self-esteem in eating disorders is ambiguous and little is known about the influence of social status as judged by others. The present study investigates whether self-esteem and peer status in early adolescence are associated with eating pathology in young adulthood.METHOD: This study is part of TRAILS, a longitudinal cohort study on mental health and social development from preadolescence into adulthood. At age 11, participants completed the Self-Perception Profile for Children, assessing global self-esteem and self-perceptions regarding social acceptance, physical appearance, and academic competence. At age 13, peer status among classmates was assessed regarding likeability, physical attractiveness, academic performance, and popularity in a subsample of 1,007 participants. The Eating Disorder Diagnostic Scale was administered at age 22. The present study included peer-nominated participants with completed measures of self-perception at age 11 and eating pathology at age 22 (N = 732; 57.8% female).RESULTS: In a combined model, self-perceived physical attractiveness at age 11 and peer popularity at age 13 were inversely correlated with eating pathology at 22 years, while likeability by peers at age 13 was positively related to eating pathology.DISCUSSION: Both self-perceptions and peer status in early adolescence are significant predictors of eating pathology in young adults. Specific measures of self-esteem and peer-perceived status may be more relevant to the prediction of eating pathology than a global measure of self-esteem.

Objective Eating disorders are understudied among male veterans, who may be at increased risk due to the high rates of trauma exposure and experiences of multiple traumatization in this population. This study sought to examine the associations between specific types of trauma (i.e., childhood physical abuse, adult physical assault, childhood sexual abuse, adult sexual assault, and military-related trauma) and eating disorder symptoms in a large, nationally-representative sample of trauma-exposed male veterans. Method Survey data were collected from N = 642 male veterans. Traumatic experiences in childhood and adulthood were assessed using the Trauma History Screen and the National Stressful Events Survey. Eating disorder symptoms were assessed with the Eating Disorder Diagnostic Scale. Analyses also controlled for age and body mass index. Results Multiple traumatization was associated with increased eating disorder symptoms. However, military-related trauma was the only trauma type that was uniquely associated with eating disorder symptoms when controlling for other trauma types. Examination of different types of military-related trauma indicated that this association was not driven by exposure to combat. Discussion Noncombat, military-related trauma was associated with eating disorder symptom severity in male veterans. Results highlight the need for better assessment of eating disorder symptoms in this population.

Bariatric surgery is an effective treatment for youth with severe obesity. However, outcomes are variable and there remains sparse understanding of predictors of weight loss following surgery. The current study examines the role of adolescent-reported pre-operative social support around exercise, binge eating, and exercise to predict excess body mass index (EBMI) loss from 3 to 12 months post-surgery. Participants were 101 adolescents ages 12–21 (M age = 16.6, SD = 1.8). Pre-operative body mass index (BMI) ranged from 35 to 87 (M = 50.3, SD = 8.6). Structural equation modeling (SEM) was used to evaluate a model of the association of adolescent report of perceived social support for exercise with less binge eating (items from the Eating Disorder Diagnostic Scale) and more self-reported exercise (items from the Youth Risk Behavior Surveillance System). The model was used to predict EBMI loss at 3, 6, 9, and 12 months post-surgery. Social support significantly predicted exercise and demonstrated a trend for predicting binge eating, such that more social support was associated with more exercise and a trend for less binge eating. Binge eating was associated with less EBMI loss. However, there was no association of exercise with EBMI loss. Pre-operative binge eating should be a target for identification and treatment prior to sleeve gastrectomy in adolescents. Although not directly or indirectly associated with EBMI loss, perceived social support around exercise was associated with increased exercise, which may make it a consideration for a target for intervention as well.

Background Eating pathology among bariatric surgery candidates is common and associated with adverse outcomes. However, its assessment is complicated by the inconsistent use of standardized measures. We addressed this by examining the use of the Eating Disorder Diagnostic Scale (EDDS) in a large bariatric sample (N = 343). Objectives To evaluate the EDDS among bariatric surgery candidates via examination of: (1) Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) and fifth edition (DSM-5) rates of binge eating disorder, bulimia nervosa, and maladaptive eating behaviors, and (2) the relationship between response biases and self-reported eating disorder symptoms. Setting Participants were bariatric surgery candidates at a large public hospital in the Midwest. Methods As part of a larger preoperative evaluation, 343 patients seeking bariatric surgery completed the EDDS and measures of problematic response bias. Results Approximately 16% of the sample met full threshold criteria for binge eating disorder using DSM-5 criteria. Using the DSM-IV-TR, rates were lower but still substantial at 13%. Rates for bulimia nervosa were 8% (DSM-5) and 6% (DSM-IV-TR). The majority (66.1%) of participants reported at least one binge-eating episode per week. The most commonly used compensatory behavior was fasting (20.4%), followed by excessive exercise (11.7%), laxative use (5.6%), and vomiting (1.8%). An inverse relationship between severity of the eating symptomatology and problematic response bias emerged. Conclusion The EDDS shows promise as a screening tool that uses diagnostic criteria to provide rates of binge eating and eating psychopathology among surgical candidates. Our findings suggest that subsequent validation studies of this measure are needed, should address potential response bias concerns, and should employ clear definitions of binge eating to promote standardization of eating pathology assessment in the bariatric population.

Objective Few longitudinal studies have investigated the role of temperament traits on weight and eating problems thus far. We investigated whether temperament in preadolescence influences body weight and the development of eating pathology in adolescence and young adulthood.Method This study used data from TRAILS (Tracking Adolescents' Individual Lives Survey), a Dutch community cohort study (N = 2,230) from preadolescence into adulthood. At age 11, the temperament dimensions negative affectivity and effortful control were measured with the Early Adolescent Temperament Questionnaire-Revised. Body mass index (BMI) was measured at all assessment waves. At age 19, the prevalence of eating disorders was investigated by two-stage screening including interviews by eating disorder experts. At age 22 and 26, the Eating Disorder Diagnostic Scale was used to assess the level of eating pathology.Results Higher negative affectivity in preadolescence was associated with higher BMI and eating pathology in young adulthood. Lower effortful control in preadolescence was found to be a risk factor for the development of obesity in young adulthood. No association was found between effortful control in preadolescence and eating pathology in later life.Discussion Both negative affectivity and effortful control play a role in the development of weight or eating problems during adolescence.

Findings from studies investigating cognitive flexibility in eating disorders (EDs) are inconsistent, and although neuropsychological tests are commonly used to measure these skills, they may not be particularly effective in predicting everyday functioning. Also, extant studies have largely focused on flexibility in anorexia nervosa (AN), with assessments targeting general rather than specific flexibility, and cognitive, rather than behavioral flexibility. Knowledge regarding ED specific flexibility and flexibility in bulimia nervosa (BN) and binge eating disorder (BED) is still scarce. The aim of this study was to develop and validate a novel measure assessing general and ED specific flexibility in a diagnostically diverse sample, and in healthy controls (HCs). A sample of 207 adult individuals with EDs (55% AN, 29% BN, 16% BED) and 288 HCs responded to an online, 51-item, pilot questionnaire on ED specific and general flexibility. In addition, participants completed the shift subscale from the Behavior Rating Inventory of Executive Function Adult version (BRIEF-A), and the Eating Disorder Diagnostic Scale (EDDS). A principal component analysis (PCA) in the clinical sample yielded a 36-item, three-factor solution capturing general flexibility, flexibility related to food and exercise, and flexibility concerning body shape and weight. Results showed that the measure had good to excellent internal consistency, and good convergent validity. A confirmatory factor analysis (CFA) using data from HCs revealed good fit indexes, supporting the original factor solution. A receiver operating characteristics analysis (ROC) demonstrated excellent accuracy in distinguishing scores from those with and without EDs. A cutoff score of 136 yielded the most balanced sensitivity and specificity. Significant differences in general and ED specific flexibility were found between individuals with and without EDs. Overall, HCs achieved the highest flexibility scores, followed by those with BED, BN, and AN. In sum this novel measure, the Eating Disorder Flexibility Index (EDFLIX) questionnaire, was found to be reliable and valid in the assessment of cognitive and behavioral flexibility, with results offering support for the conceptual distinction between general and ED related flexibility. The study also provides strong evidence for the discriminant validity of the EDFLIX with results revealing significant differences in flexibility in people with and without EDs. In addition, significant differences in flexibility also emerged when comparing diagnostic groups, indicating the utility of the assessment instrument for classification purposes.

Background Depression and Binge Eating Disorder (BED) are prevalent among bariatric surgery candidates. Depression subtypes may be differentially related to obesity, such that the atypical subtype predicts poorer outcomes. However, no research has examined depression subtypes, BED, and weight loss in bariatric candidates Objective To examine whether pre-surgical atypical depressive symptoms, compared to no depressive and melancholic depressive symptoms, were associated with higher rates of pre-surgical BED, binge eating severity, and poorer post-surgical weight loss trajectories among bariatric candidates Setting An outpatient Midwest bariatric clinic Method Participants were 345 adults (aged 46.27±12.78 years, 76% female; BMI=49.84±8.51kg/m2) who received a pre-surgical evaluation. Depression subtypes (melancholic, atypical, and no depressive symptoms) were categorized using the Beck Depression Inventory-II. BED diagnosis and severity were evaluated using the Eating Disorder Diagnostic Scale and Binge Eating Scale, respectively. Weight loss trajectories were calculated as percent total body weight loss (%TBWL) post-surgery. Results Using no depression as the referent, participants reporting melancholic symptoms (OR=7.60, p Conclusions Patients reporting pre-operative atypical depressive symptoms were more likely to meet criteria for comorbid BED diagnosis and have greater binge eating severity but did not have poorer weight loss within 18-months post-surgery. Future studies with longer-term follow-up and corresponding measures of post-surgical depression and binge eating pathology are warranted.

Objective: The Yale Food Addiction Scale (YFAS) is the only questionnaire that assesses food addiction (FA) based on substance dependence criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM), Fourth Edition, Text Revision. Following recent updating of addiction criteria, a new DSM-5 version (YFAS 2.0) has been developed. Our study tested the psychometric properties of the French YFAS 2.0 in a nonclinical population. Method: We assessed 330 nonclinical participants for FA (French YFAS 2.0), eating behaviour, and eating disorder (Binge Eating Scale, Emotional Overeating Questionnaire, Three-Factor Eating Questionnaire-R18, Questionnaire on Eating and Weight Patterns-Revised, Eating Disorder Diagnostic Scale). We tested the scale’s factor structure (confirmatory factor analysis based on 11 diagnostic criteria), internal consistency, and construct and incremental validity. Results: Prevalence of FA was 8.2%. Our results supported a 1-factor structure similar to the US version. In both its diagnostic and symptom count versions, the YFAS 2.0 had good internal consistency (Kuder-Richardson alpha was 0.83) and was associated with body mass index (BMI), binge eating, uncontrolled and emotional eating, binge eating disorder, and cognitive restraint. FA predicted BMI above and beyond binge eating frequency. Females had a higher prevalence of FA than males but not more FA symptoms. Conclusions: We validated a psychometrically sound French version of the YFAS 2.0 in a nonclinical population, in both its symptom count and diagnostic versions. Future studies should investigate psychometric properties of this questionnaire in clinical populations potentially at risk for FA (that is, patients with obesity, diabetes, hypertension, or other metabolic syndrome risk factors).

INTRODUCTION: Eating disorders have been intensively researched over recent decades. However, there has been insufficient research into the early assessments for detecting the risk of developing disordered eating. We report preliminary results from a project aiming to assess the prevalence of eating attitudes and behaviors that heighten the risk of eating disorders. The study examines a non-clinical sample of adolescents and adults from two cities of South Bulgaria.METHODS: In this cross-sectional epidemiological study, a total of 1285 volunteers of 828 females and 453 males, aged 14 to 59 years, were surveyed to assess disordered eating attitudes and behaviors. For this purpose, the study used the ‘SCOFF’ questionnaire, the Eating Disorder Diagnostic Scale (EDDS), and the Eating Attitudes and Behaviors Questionnaire (EABQ), which was developed for this study.RESULTS: The proportion of these volunteers underweight (body mass index below 17.5) was 9.8%. Of the total subject, 34.7% provided two or more positive answers for the SCOFF questionnaire (two being the upper threshold for indicating 100% sensitivity to anorexia and bulimia). The results differed between males and females: 21.6% and 42.1%, respectively, in this regard. A factor analysis (oblimin rotation) of EABQ items revealed four main factors: body shape and weight concerns, personal control over eating and calorie intake, dieting, and preoccupation with food and binge eating. A Spearman’s correlation analysis showed moderately significant correlations (p < 0.001) between the total scores of the SCOFF questionnaire, EABQ, and the scores for three groups of items in the EDDS for assessing eating attitudes and behaviors.CONCLUSION: We found a greater ED risk in adolescents compared with the older groups and in females compared with males. One fifth of males studied were at high risk of ED and ages between 19 and 39 years also appeared at risk. The EABQ was validated as a sensitive and reliable self-report instrument that can be used for early detection for the risk of ED. Our results could form a basis for developing programs in disordered eating prevention.

Previous research on 'food addiction' as measured with the Yale Food Addiction Scale (YFAS) showed a large overlap between addiction-like eating and bulimia nervosa. Most recently, a revised version of the YFAS has been developed according to the changes made in the diagnostic criteria for substance use disorder in the Diagnostic and Statistical Manual of Mental Disorders fifth edition. The current study examined prevalence and correlates of the YFAS2.0 in individuals with bulimia (n = 115) and controls (n = 341). Ninety-six per cent of participants with bulimia and 14% of controls received a YFAS2.0 diagnosis. A higher number of YFAS2.0 symptoms was associated with lower interoceptive awareness, higher depressiveness, and higher impulsivity in both groups. However, a higher number of YFAS2.0 symptoms was associated with higher body mass and weight suppression in controls only and not in participants with bulimia. The current study is the first to show a large overlap between bulimia and 'food addiction' as measured with the YFAS2.0, replicating and extending findings from studies, which used the previous version of the YFAS. Compensatory weight control behaviours in individuals with bulimia likely alleviate the association between addiction-like eating and higher body mass. Thus, the large overlap between bulimia and 'food addiction' should be taken into consideration when examining the role of addiction-like eating in weight gain and obesity. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

Men remain largely underrepresented in the eating disorder literature and few studies have investigated risk factors for disordered eating among men. The current study examined associations between Big Five personality traits and eating disorder symptoms in a sample of college men (N = 144). Participants completed the Eating Disorder Diagnostic Scale and Ten Item Personality Inventory online. Results suggested that openness was positively associated with purging-type behaviors and that emotional stability was positively related to symptoms of anorexia nervosa and global eating pathology. Findings highlight the prevalence of eating disorder symptoms among college men and suggest that these symptoms are associated with a different constellation of personality traits than is typically reported among women. Implications for targeted prevention and intervention programs and future research are discussed.

Objective Eating disorders are understudied in men and in sexual minority populations; however, extant evidence suggests that gay men have higher rates of disordered eating than heterosexual men. The present study examined the associations between sexual orientation, body mass index (BMI), disordered eating behaviors, and food addiction in a sample of male veterans. Method Participants included 642 male veterans from the Knowledge Networks-GfK Research Panel. They were randomly selected from a larger study based on previously reported trauma exposure; 96% identified as heterosexual. Measures included the Eating Disorder Diagnostic Scale, the Yale Food Addiction Scale, and self-reported height and weight. Results Heterosexual and sexual minority men did not differ significantly in terms of BMI. However, gay and bisexual men ( n =24) endorsed significantly greater eating disorder symptoms and food addiction compared to heterosexual men. Conclusions Our findings that sexual minority male veterans may be more likely to experience eating disorder and food addiction symptoms compared to heterosexual male veterans highlight the importance of prevention, assessment, and treatment efforts targeted to this population.

Objective To determine prevalence rates and clinical correlates of current DSM-5 eating disorders in patients with bipolar disorder (BP). Methods Prevalence rates of current DSM-5- and DSM-IV-defined binge eating disorder (BED), bulimia nervosa (BN), and anorexia nervosa (AN) were assessed with the Eating Disorder Diagnostic Scale (EDDS) in 1092 patients with BP. Psychiatric illness burden was evaluated with five proxy measures of BP illness severity. Medical illness burden was evaluated with the Cumulative Index Rating Scale (CIRS). Results Twenty-seven percent of patients had a current DSM-5 eating disorder: 12% had BED, 15% had BN, and 0.2% had AN. Rates of DSM-5-defined BED and BN were higher than clinical diagnosis rates and rates of DSM-IV-defined BED and BN. Compared with BP patients without an eating disorder, BP patients with a DSM-5 eating disorder were younger and more likely to be women; had an earlier age of onset of BP; had higher EDDS composite scores and higher degrees of suicidality, mood instability, and anxiety disorder comorbidity; and had a higher mean BMI, higher rate of obesity, and higher CIRS total scores. In a logistic regression model controlling for previously identified correlates of an eating disorder, younger age, female gender, and higher BMI remained significantly associated with an eating disorder. Limitations The EDDS has not been validated in BP patients. Conclusion DSM-5-defined BED and BN are common in BP patients, possibly more common than DSM-IV-defined BED and BN, and associated with greater psychiatric and general medical illness burden. Further studies assessing DSM-5 eating disorders in people with BP are greatly needed.

Purpose To examine the potential factor structure of the Eating Disorder Diagnostic Scale (EDDS) in a sample of individuals with bipolar disorder. Method Exploratory common factor analyses were conducted in a sample of 1031 people with bipolar disorder as defined by the Structured Clinical Interview for DSM-IV-TR. Results Approximately 27% of participants had a comorbid eating disorder. Exploratory factor analysis yielded a 3 factor solution (i.e., shape/weight concerns; binge eating behaviors, compensatory behavior). Conclusions The 3-factor solution of the EDDS in a bipolar disorder sample is consistent with major eating disorder symptom domains. Future research is necessary to replicate these findings in eating disorder samples with diverse comorbid psychopathology.

This article presents the psychometric properties for the Portuguese population of a brief self-report scale for diagnosing anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED): the Eating Disorder Diagnostic Scale (Stice et al., 2000).Method: To study the psychometric properties of EDDS, an exploratory factor analysis was done first, followed by a confirmatory factor analysis.Results: The results of the exploratory factor analysis revealed the existence of three components and the confirmatory factor analysis showed a structure with three latent variables (Body and Weight Concerns, Binge Eating Behaviour and Compensatory Behaviours), with a second order variable (Eating Disorder Symptoms) with a good adjustment fit. The internal consistency and the test-retest correlations revealed an adequate reliability and the inter-correlations of the EDDS subscales with other measures of the same and different constructs, supported the convergent and discriminant validity of this measure.Conclusions: Summing up, the EDDS seems to be a useful measure to assess eating disorders symptomatology in the Portuguese population. (C) 2018 Sociedad Espanola para el Estudio de la Ansiedad y el Estres - SEAS. Published by Elsevier Espana, S.L.U. All rights reserved., En este artículo se presentan las propiedades psicométricas para la población portuguesa de una escala breve de autoinforme para el diagnóstico de la anorexia nerviosa, la bulimia nerviosa y el trastorno por atracones: la Escala de Diagnóstico del Trastorno Alimentario (EDTA; Stice, Telch y Rizvi, 2000). Método Para estudiar las propiedades psicométricas de la EDTA se efectuó un análisis factorial exploratorio, seguido por un análisis factorial confirmatorio. Resultados Los resultados del análisis factorial exploratorio muestran la existencia de 3 componentes y el análisis confirmatorio evidencia una estructura con 3 variables latentes (preocupaciones sobre el cuerpo y el peso, comportamientos de ingesta por atracones y conductas compensatorias), con un factor de segundo orden (síntomas de trastornos de alimentación) con un buen ajuste. La consistencia interna y las correlaciones test-retest muestran una confiabilidad adecuada, y las intercorrelaciones de las subescalas de la EDTA con otras medidas del mismo y de diferentes constructos fortalecen la validez convergente y discriminante de la medida. Conclusiones En resumen, la EDTA parece ser una medida útil para evaluar sintomatología de trastornos de la alimentación en la población portuguesa., (undefined)

AIMS: Anecdotal evidence suggests that actors and other performing artists are under great pressure to conform to idealized appearances and body types. The pursuit of such appearances may trigger eating disorder symptoms, such as unhealthy attitudes towards body weight and shape. Thus far, there has been no dedicated empirical study of the prevalence of such problems in Australian actors and performing artists specifically. Therefore, this study sought to examine eating disorder symptomatology in Australian actors and performing artists. METHODS: An online survey was distributed to the Equity Foundation membership representing Australian actors and performing artists, of whom 573 individuals completed the survey. This survey gauged demographic information and eating disorder symptoms using the psychometrically validated Eating Disorder Diagnostic Scale (EDDS). RESULTS: A large proportion of actors reported unhealthy attitudes such as ‘feeling fat’ even though they are of normal weight or underweight; reported an extreme fear of gaining weight; and evaluated their self-worth based on their body weight and shape, particularly women. Results also showed that 2.5% of women in the study met the diagnostic criteria for anorexia nervosa and 13% met diagnostic criteria for bulimia nervosa based on their scores on the EDDS. DISCUSSION: Performers may be a particularly at-risk population for the development and/or maintenance for a range of eating disorders.

Objective Eating disorders are understudied among female U.S. military veterans, who may be at increased risk due to their high rates of trauma exposure and trauma-related sequelae. The current study sought to examine whether different types of trauma in childhood and adulthood confer differential risk for eating disorder symptoms (EDSs) in this population. Method We analyzed survey data from a sample of female Veterans Health Administration patients (N = 186) to examine the association between 5 trauma types (i.e., childhood physical abuse, adult physical assault, childhood sexual abuse, adult sexual assault, and military-related trauma) and EDS severity. Results Approximately 14% of the sample reported clinical levels (i.e., standardized Eating Disorder Diagnostic Scale score ≥16.5) of EDSs. Multiple traumatization was associated with increased EDSs. Adult physical assault, adult sexual assault, and military-related trauma were individually associated with more severe eating disorder symptomatology, though only military-related trauma was uniquely associated with disordered eating in the full model. Discussion EDSs are common among female veterans, and trauma exposures are differentially associated with symptom severity. It is critical to assess for EDSs in female veterans, particularly those with a history of military-related trauma, to facilitate detection and appropriate treatment. (PsycINFO Database Record

Introduction: Dieting, obsessive weight control practices, fears of fatness, negative body image, food and weight preoccupation and other distorted attitudes and behaviors are proven risk factors with a serious potential to facilitate the development of anorexia and bulimia nervosa and the so called “atypical ED”. They are not enough studied in Bulgaria. The purpose of this study was to assess the prevalence and the gender differences in disordered eating attitudes and behaviors in adolescents and young adults from Bulgaria. Methods: We studied two age groups 886 (80.7%) adolescents from 14 to 19 years and 212 (19.3%) young adults from 20 to 40 years, 402 male and 696 female. The respondents were Bulgarian high school students, undergraduate university students and volunteers from the general population with higher education. All participants anonymously completed the Eating attitudes and behaviors questionnaire (EABQ); Bulgarian version of the SCOFF, The Eating Disorder Diagnostic Scale (EDDS) and gave information about their age, gender, height and weight, the lowest body weight during the last three months; the frequency of measuring the body weight. We calculated three composite EDDS sub-scores. Results: The boys and girls total and composite questionnaires scores differed significantly. There were no significant gender differences in young adults, except for EABQ total score. The mean ranks in the adolescent group showed that the female subjects reported more disordered eating behavior and risky attitudes compared with the males. In both age groups, the total SCOFF and EABQ scores and the composite scores of EDDS correlated significantly and proportionally (Spearman’s correlation, p

Objectives DSM-5 changes for eating disorders (EDs) aimed to reduce preponderance of non-specified cases and increase validity of specific diagnoses. The objectives were to estimate the combined effect of changes on prevalence of EDs in adolescents and examine validity of diagnostic groupings. Method A total of 3043 adolescents (1254 boys and 1789 girls, Mage = 14.19 years, SD = 1.61) completed self-report questionnaires including the Eating Disorder Diagnostic Scale. Results Prevalence of full-threshold EDs increased from 1.8% (DSM-IV) to 3.7% (DSM-5), with a higher prevalence of bulimia nervosa (1.6%) and the addition of the diagnosis of purging disorder (1.4%); prevalence of binge eating disorder was unchanged (0.5%), and non-specified cases decreased from 5.1% (DSM-IV) to 3.4% (DSM-5). Validation analyses demonstrated that DSM-5 ED subgroups better captured variance in psychopathology than DSM-IV subgroups. Discussion Findings extend results from previous prevalence and validation studies into the adolescent age range. Improved diagnostic categories should facilitate identification of EDs and indicate targeted treatments. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.

Activation of schemas related to one’s appearance has been studied extensively using implicit tasks such as the word stem completion task and the Stoop paradigm. The current study utilized a word stem completion task adapted for presentation on a Personal Data Assistant to examine differences in reaction times to appearance- and non-appearance-related words. Participants were 93 undergraduate women, 30 of whom met criteria for eating psychopathology utilizing the diagnostic algorithm for the Eating Disorder Diagnostic Scale (Stice et al. in Psychol Assess 12:123–131. doi:10.1037/1040-3590.12.2.123, 2000). The remaining 63 participants served as a comparison group. A significant interaction effect indicated that women with eating pathology exhibited significantly longer reaction times when selecting the appearance-related words than those without eating psychopathology. This research introduces a novel method of measuring reaction time to appearance- and non-appearance-related words and demonstrates the relevance of appearance schematicity in the naturalistic environment by showing that these schemas have the potential to impact the way young women process schema-relevant information on a day-to-day basis.

This paper was developed as a part of discussions related to the World Health Organization’s (WHO’s) revision of the ICD-10, although the ideas presented here do not represent official proposals. The changes in the classification of feeding and eating disorders (EDs) in the upcoming ICD-11 necessitate the development of new diagnostic/ screening instruments as old instruments will become less relevant because they will not be consistent with the most up-to-date diagnostic systems unless they are revised. This paper describes the process of development of one such computerized tool for assessment and diagnosis of EDs according to ICD-11. At present, the Composite International Diagnostic Interview (CIDI), the Eating Disorder Examination (EDE) and its self-report questionnaire version the EDE-Q are used most commonly to generate ED diagnoses or rate ED psychopathology, respectively [1, 2]. The CIDI, developed by the WHO, can generate diagnoses for both the ICD-10 and the DSM-IV [1] but requires training for proper use. The EDE/EDE-Q [2], in contrast, provide extensive information on multiple eating problems and is often considered the method of choice for assessment of EDs but does not generate ICD-10 diagnoses. Numerous other screening and diagnostic tools, including the Eating Attitudes Test [3], Body Attitudes Questionnaire [4], Questionnaire for Eating Disorder Diagnoses [5], Eating Disorder Diagnostic Scale [6], SCOFF questionnaire [7], Minnesota Eating Behavior Survey [8], look into specific aspects of ED without necessarily generating ICD diagnosis. Rather, use of these multiple instruments results in wide variations in the reported prevalence of ED and makes studies difficult to compare. Thus the need for a research and diagnostic tool that reflects the current classification of EDs becomes paramount. Further, in lowand middle income countries, EDs are likely to be dealt with in primary health-care settings, possibly by nurses or other health care workers without training in mental health. Even in high-income countries, sufferers of ED are likely to wait for a considerable time before being seen by an ED specialist [9]. Individuals suffering from EDs and their parents or other carers often want a simple method that can help them decide whether there is a need to seek help. Thus, in order to recognise EDs and their development at an early stage, we aim to provide a computerized questionnaire that can also be used as a semi-structured interview for the understanding of eating problems. Additionally, this software has its utility as a tool to create ICD11 ED classifications and codes proposed in a companion paper (Thiels, this issue).

Objectives This study aimed to investigate eating disorder diagnostic status and related symptoms in early pregnancy. Methods Pregnant women (n=739), attending their first routine antenatal scan, were assessed using an adapted version of the Eating Disorder Diagnostic Scale (EDDS). Prevalence estimates and eating disorder symptoms were assessed during the first 3 months of pregnancy and, retrospectively, in the 6 to 12 months prior to pregnancy. Results During pregnancy 7.5% of women met diagnostic criteria for an eating disorder, compared to prepregnancy prevalence of 9.2%. Approximately one quarter (23.4%) of women reported high weight and shape concern during pregnancy; binge eating was endorsed by 8.8%, and 2.3% of women engaged in regular compensatory behaviours. Conclusions Eating disorders are more common than previously thought in pregnancy. There is a clinical need for increased understanding of eating disorder symptomatology during pregnancy and for appropriate screening tools to be incorporated into antenatal care. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.

European Union (EU) Horizon 2020 ERC-StG-2014 639445 “NewEat”

Objective To determine whether bipolar spectrum disorder with binge eating behavior (BE) is an important clinical sub-phenotype. Methods Prevalence rates and correlates of different levels of BE were assessed in 1114 bipolar spectrum patients participating in a genetic biobank. BE and eating disorders (EDs) were assessed with the Eating Disorder Diagnostic Scale (EDDS). Psychiatric illness burden was evaluated with measures of suicidality, psychosis, mood instability, anxiety disorder comorbidity, and substance abuse comorbidity. Medical illness burden was evaluated with body mass index (BMI) and the Cumulative Index Rating Scale (CIRS). Results Thirty percent of patients had any BE and 27% had BE plus an ED diagnosis. Compared with bipolar spectrum patients without BE, bipolar spectrum patients with BE were younger and more likely to be female; had significantly higher levels of eating psychopathology, suicidality, mood instability, and anxiety disorder comorbidity; had a significantly higher mean BMI and a significantly higher rate of obesity; and had a significantly higher medical illness burden. Bipolar spectrum patients with BE but no ED diagnosis were more similar to bipolar spectrum patients without BE than to those with an ED. Nonetheless, the positive predictive value and specificity of BE predicting an ED was 0.90 and 0.96, respectively. Limitations As only two patients had co-occurring anorexia nervosa, these results may not generalize to bipolar spectrum patients with restricting EDs. Conclusion Bipolar spectrum disorder with broadly-defined BE may not be as clinically relevant a sub-phenotype as bipolar spectrum disorder with an ED but may be an adequate proxy for the latter when phenotyping large samples of individuals.

Background: Female athletes tend to consume improper for supporting their performance, so that can impact eating disorder. Eating disorder can lead menstrual irregularity and osteoporosis for them, so they have risk of female athlete triad. The aimed of this study to determine prevalence of female athlete triad in education and training centre (PUSDIKLAT) Ragunan Jakarta. Methods: Descriptive research with cross sectional design, and calculation of total subject used stratified proportional random sampling. The sample was composed of 65 female athletes in Education and Training Center (PUSDIKLAT) Ragunan Jakarta. Data include nutritional status, eating disorder, menstrual disorder, and bone density. Assessment of nutritional status used BMI/A percentile and percent body fat; measurement of percent body fat used body fat analyzer HBF 200; assessment of eating disorder used eating disorder diagnostic scale ; measurement of menstrual irregularity used questionnaire including frequency, menstrual cycle, menarche, and menstruation on last 3 months; and measurement of bone density used quantitative ultrasound bone densitometry. Result: Female athlete triad not found on subjects, but 15 subjects (23.1%) had bulimia and 1 subject (1.5%) had menstrual irregularity, i.e oligoamenorrhea , whereas bone density of all subjects (100%) normal, so that only 1 subject (1.5%) had two symptom of female athlete triad (bulimia and oligoamenorrhea).fifty six subjects (86,2%) had normal nutritional status. Based on fat body percent, that was found 1 subject (1.5%) having underfat, 10 subjects (15.4%) overfat, and 2 subjects (3.1%) obese. Conclusion : Female athlete triad not found in Education and Training Center (PUSDIKLAT) Ragunan Jakarta

Most measures of eating disorder symptoms and risk factors were developed in predominantly White female samples. Yet eating disorders affect individuals of all racial and ethnic backgrounds. Black women appear more vulnerable to certain forms of eating pathology, such as binge eating, and less susceptible to other eating disorder symptoms and risk factors, such as body dissatisfaction, compared with their White peers. Despite concern that extant measures do not adequately assess eating concerns among Black women, the construct validity of scores on most of these measures has not been adequately examined within this population. This study included 2,208 Black and White women who completed the following: the Binge Eating Scale (BES), the Eating Disorder Diagnostic Scale (EDDS), the Eating Attitudes Test-26 (EAT-26), the Eating Disorder Inventory Body Dissatisfaction and Drive for Thinness subscales, the Bulimia Test-Revised (BULIT-R), the Multidimensional Body-Self Relations Questionnaire-Appearance Evaluation subscale (MBSRQ-AE), and the Objectified Body Consciousness Scale (OBCS). Most measures yielded internally consistent scores in both races. Confirmatory factor analyses indicated that loadings for some measures, including the EAT-26 and EDDS, were not invariant across groups and thus do not assess equivalent constructs in White and Black women. However, others, including the BULIT-R, BES, OBCS, and MBSRQ-AE, exhibited factorial invariance in both races. Results suggest scores are likely not equivalent across races for several popular measures of eating disorder symptoms and risk factors. Thus, it is recommended that researchers and clinicians obtain additional information regarding racial/cultural factors when using these instruments with Black women.

The Eating Disorder Diagnostic Scale (EDDS) is a brief self-report measure for diagnosing anorexia nervosa, bulimia nervosa and binge eating disorder. Research has provided evidence of the reliability and validity of this scale in non-clinical populations. Our study is the first to examine the psychometric features of the EDDS in a clinical population of eating disordered patients. We identified a cut-off point that differentiates clinical patients from healthy controls. A clinical group of 59 Dutch female eating disordered patients and a control group of 45 Dutch students completed the EDDS, the Eating Disorder Examination Interview, the Body Attitude Test and the Beck Depression Inventory--II. The EDDS showed good test-retest reliability, internal consistency, criterion validity and convergent validity with other scales assessing eating and general pathology. An overall symptom composite cut-off score of 16.5 accurately distinguished clinical patients from healthy controls. The EDDS may be a useful instrument in clinical settings and in aetiologic, prevention and treatment research.

Current study aimed to offer structural model regarding role of Self-Concept and Self-Handicapping in eating disorder. Looking at high trend of morbidity and mushrooming number of eating disorder in clinical and non-clinical settings and its antagonistic features among afflicted individuals, and with respect to clinical implication and, theoretical dimensions, conducting current study seemed inevitable. Materials and Methods: This study was descriptive-correlational study. Statistical society of current study consisted of 750 individuals with BMI≥25, who were admitted to nutrition clinic at Sari General Hospital (Sari, Iran). Sample size was specified as 226 according to Krejcie and Morgan Table. We used Beck Self-Concept Test (BSCT) with respect to assessing self-concept, SHS with respect to self-handicapping assessment, EDDS (Eating disorder diagnostic scale) regarding assessment of eating disorders (anorexia nervosa, bulimia nervosa and binge eating disorder). With respect to data analyze, SPSS-22 and structural equation modeling and regression model via Lisrel test were used. Results: According to results of current study, self-concept and self-handicapping pose positive and influential roles with respect to anorexia nervosa, bulimia nervosa and binge eating disorder. Conclusion: Eating disorders are one of the leading causes of disturbance especially among women. Various factors are involved in pathogenesis of this disorder. In current study we delineated structural model with respect to Self-Concept and Self-Handicapping and eating disorders.

Introduction Eating disorders indicate unhealthy habits in nutrition and/or behaviour in the feeding and maintaining of body weight. The main characteristic of these diseases is changed behaviour in nutrition, either as an intentional restriction of food, namely extreme dieting or overeating, i.e. binge eating. Extreme dieting, skipping meals, self-induced vomiting, excessive exercise, and misuse of laxatives and diuretics for the purpose of maintaining or reducing body weight are the forms of compensatory behaviour. Objective The purpose of the present research was to determine the presence of different inappropriate compensatory behaviours among eating disordered patients. Methods The experimental group included 35 female eating disordered patients of 23.02?}3.46 years on average, with anorexia or bulimia nervosa. The control group consisted of 70 girls aged 23.1?}3.0 years on average. Each participant completed a '24-hour Recall Questionnaire' and the 'Eating Disorder Diagnostic Scale'. Results A high statistically significant difference existed in the presence of all compensatory behaviours in the experimental and control group, regarding vomiting (?2=40.6; p

This research assessed the prevalence and sociodemographic correlates of eating disorder symptoms among young people from China. A sample of 1320 females and 783 males between 12 and 22 years of age was recruited from academic settings in various regions of China and completed a back-translated Chinese version of the Eating Disorder Diagnostic Scale, as well as measures of body dissatisfaction and demographics. As expected, reported eating disorder symptoms and body dissatisfaction were significantly higher for females than males. Eating disorder symptoms and body dissatisfaction were also more pronounced for participants from higher income households. Finally, age differences in symptoms and body dissatisfaction were inconsistent. In sum, findings extend past prevalence research and highlight specific sociodemographic correlates of eating pathology and body dissatisfaction among Chinese adolescents and young adults.