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ObjectiveOur research focuses on laxative misuse, which has been understudied in previous eating disorders (ED) research, to understand its prevalence and correlates among individuals seeking ED treatment. We also test the association between laxative misuse and binge eating to examine the assumption that laxative misuse is intended to compensate for binge eating.MethodParticipants were 2,295 ED treatment-seeking adults (29.5 ± 10.5) who self-reported their disordered eating behaviors on the Eating Disorder Questionnaire. Participants met DSM-5 diagnostic criteria for anorexia nervosa (AN: 11.5%, n = 264), bulimia nervosa (BN: 39.0%, n = 896), binge-eating disorder (14.9%, n = 343), or other specified feeding or eating disorder (34.5%, n = 792).ResultsNearly 25% of participants (n = 571) reported misusing laxatives during the last month. Laxative misusers with AN reported significantly higher frequency of laxative misuse relative to misusers with BN (F(1,440) = 5.226, p = .023, ηp2= .012). Among laxative misusers, there was no association between frequency of binge eating and frequency of laxative misuse.DiscussionLaxative misusers with AN tend to misuse laxatives more frequently than those with BN. Binge eating was not related to laxative misuse in our sample. Future research may use real-time data collection to understand the function of laxative misuse and to validate our cross-sectional findings.

We examined eating disorders in midlife and beyond by comparing frequency of anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified feeding or eating disorder (OSFED) among midlife eating disorder treatment-seeking individuals and younger controls. We also compared demographic and eating disorder-related characteristics across diagnoses and age groups. Participants included 2,118 treatment-seeking adults who self-reported their eating-related symptoms on the Eating Disorder Questionnaire. Results showed that percent of patients with BN was significantly lower whereas percent of patients with BED and OSFED was significantly higher among midlife relative to younger patients. Percent of patients with AN did not differ between midlife and younger patients. Additionally, midlife and younger patients with BED and OSFED differed on several demographic (e.g., marital status) and eating disorder-related characteristics (e.g., BMI, compulsive exercising). This study suggests that BN is less common whereas BED and OSFED are more common among midlife eating disorder treatment-seeking individuals relative to younger controls. In addition, AN and BN present fairly similarly whereas BED and OSFED present fairly differently among midlife patients relative to younger controls. Attention to these differences and similarities is necessary to understand eating disorders in midlife.

ObjectiveTo compare dietary restriction behaviors among adults with eating disorders involving binge eating, including anorexia nervosa-binge/purge subtype (AN-BE/P), bulimia nervosa (BN), and binge eating disorder (BED), and to examine whether dietary restriction behaviors impact binge eating frequency across diagnoses.MethodParticipants included 845 treatment seeking adults (M=30.42+10.76years) who met criteria for DSM-5 AN-BE/P (7.3%;n=62), BN (59.7%;n=504), and BED (33.0%;n=279). All participants self-reported their past and current eating disorder symptoms on the Eating Disorder Questionnaire.ResultsAdults with AN-BE/P and BN reported significantly more dietary restriction behaviors (e.g. eating fewer meals per day, higher frequency of fasting, consuming small and low calorie meals) in comparison to adults with BED. Adults with AN-BE/P and BN who reported restricting food intake via eating fewer meals per day had more frequent binge eating episodes. However, adults with BN who reported restricting food intake via eating small meals and low calorie meals had less frequent binge eating episodes.DiscussionThis study provides mixed support for the restraint model by suggesting that not all dietary restriction behaviors are associated with higher levels of binge eating. It may be that adults with BN who report a higher frequency of eating small and low calorie meals display more control over their eating in general, and therefore also have lower frequency of binge eating. Clinicians should assess for dietary restriction behaviors at the start of treatment prior to assuming that all forms of strict dieting and weight control behaviors similarly impact binge eating.

ObjectiveTo describe eating patterns in youth with restricting and binge/purge type anorexia nervosa (AN) and to examine whether eating patterns are associated with binge eating or purging behaviors.MethodParticipants included 160 children and adolescents (M = 15.14 ± 2.17 years) evaluated at The University of Chicago Eating Disorders Program who met criteria for DSM-5 restrictive type AN (AN-R; 75%; n = 120) or binge eating/purging type AN (AN-BE/P; 25%; n = 40). All participants completed the eating disorder examination on initial evaluation.ResultsYouth with AN-R and AN-BE/P differed in their eating patterns, such that youth with AN-R consumed meals and snacks more regularly relative to youth with AN-BE/P. Among youth with AN-BE/P, skipping dinner was associated with a greater number of binge eating episodes (r = -.379, p

PurposePrevious studies on family meals and disordered eating have mainly drawn their samples from the general population. The goal of the current study is to determine family meal frequency among children and adolescents with anorexia nervosa (AN), bulimia nervosa (BN), and feeding or eating disorder not elsewhere classified (FED-NEC) and to examine whether family meal frequency is associated with eating disorder psychopathology.MethodsParticipants included 154 children and adolescents (M = 14.92 ± 2.62), who met criteria for AN (n = 60), BN (n = 32), or FED-NEC (n = 62). All participants completed the Eating Disorder Examination and the Family Meal Questionnaire prior to treatment at the University of Chicago Eating Disorders Program.ResultsAN and BN participants significantly differed in terms of family meal frequency. A majority of participants with AN (71.7%), compared with less than half (43.7%) of participants with BN, reported eating dinner with their family frequently (five or more times per week). Family meal frequency during dinner was significantly and negatively correlated with dietary restraints and eating concerns among participants with BN (r = -.381, r = -.366, p < .05) and FED-NEC (r = -.340, r = -.276, p < .05).ConclusionsAN patients' higher family meal frequency may be explained by their parents' relatively greater vigilance over eating, whereas families of BN patients may be less aware of eating disorder behaviors and hence less insistent upon family meals. Additionally, children and adolescents with AN may be more inhibited and withdrawn and therefore are perhaps more likely to stay at home and eat together with their families.

Little is known about the therapeutic alliance (TA) formed with different professionals in multidisciplinary eating disorder (ED) treatment, particularly in the context of online treatment during the COVID-19 pandemic. We aimed to conduct a pilot study during the COVID-19 pandemic examining characteristics of patients' TA with their dieticians and psychotherapists, associations between patients' and therapists' views of the TA, and relationships between psychological characteristics and TAs. Sixty-three patients with EDs and their treating psychotherapists and dieticians were surveyed during the COVID-19 pandemic using the Working Alliance Inventory (WAI-S). Spearman correlation tests were used to examine associations between variables. Positive associations were found between the TAs examined. Concordance was stronger in patient-dietician dyads than in patient-psychotherapist dyads. Severe ED psychopathology was associated with weaker TA (bond subscale). General psychopathology was associated with weaker TA with the dietician (task subscale). Given that several differences were found between the TAs of treatment dyads, further longitudinal studies are needed to validate our pilot findings and to investigate multidisciplinary TAs and their impact on treatment outcomes in online ED treatment settings during the COVID-19 pandemic, as well as in other treatment settings (e.g., in-person settings). This study will contribute to a deeper understanding of the dynamics of TAs in multidisciplinary ED treatment and inform the development of more effective interventions. [ABSTRACT FROM AUTHOR]

Aims: To assess the prevalence and disease‐related risk factors for disordered eating behaviours among adolescents with type 1 diabetes and also to search for risk factors at disease diagnosis that can predict the development of disordered eating behaviours. Methods: A retrospective observational study of 291 adolescents aged 15–19 years with type 1 diabetes who completed the Diabetes Eating Problem Survey‐Revised (DEPS‐R) as is routine in our diabetes clinic. The prevalence of disordered eating behaviours and risk factors for their development was assessed. Results: In 84 (28.9%) adolescents, disordered eating behaviours were found. Disordered eating behaviours were positively associated with female sex (β = 3.01 [SE = 0.97], p = 0.002), higher BMI‐Z score (β = 2.08 [SE = 0.49], p < 0.001), higher HbA1c (β = 0.19 [SE = 0.03], p < 0.001) and treatment with multiple daily injections of insulin (β = 2.19 [SE = 1.02], p = 0.032). At type 1 diabetes diagnosis, higher BMI‐Z score (β = 1.54 [SE = 0.63], p = 0.016) for those diagnosed before age 13 years and increased weight gain at 3 months post‐diagnosis (β = 0.88 [SE = 0.25], p = 0.001) in females diagnosed at age 13 years or older were found to be risk factors for disordered eating behaviours. Conclusions: Disordered eating behaviours are common among adolescents with type 1 diabetes and are associated with various parameters, including BMI at diagnosis and the rate of weight gain at 3 months post‐diagnosis in females. Our findings highlight the need for early preventive efforts for disordered eating behaviours and interventions to avoid late diabetes complications. [ABSTRACT FROM AUTHOR]

Neighborhood violence is associated with poor health, but the mechanisms explaining this association are still unknown. This study seeks to examine the role of loneliness as a mediator of the association between neighborhood violence and health among two ethnic groups (Arabs and Jews) in Israel. A representative survey was conducted among adult residents (1903 Arabs and 2726 Jews) of four Israeli towns: two Arab towns, one Jewish town and one mixed town. A stratified sample of households by residential area, age and sex, was selected in each town. Mediation models were tested using Hayes' PROCESS procedure. Traffic violations, juvenile delinquency and vandalism were reported by more than 50% of Arab residents, relative to about 25–30% of Jewish residents. Loneliness mediated the association between neighborhood violence and health, with a full serial mediation for mental health and a partial serial mediation for physical health. Findings indicate that Arab towns are characterized by severe neighborhood violence. The association between neighborhood violence and physical health was fully dependent on the mediators among both ethnic groups. Future studies should use prospective designs with objective measures of health and violence to validate our cross-sectional findings. [ABSTRACT FROM AUTHOR]

Drawing on socioemotional selectivity theory, we examined the effect of COVID-19 lockdowns on perceptions of romantic relationships quality among older, compared to younger, adults. During the first lockdown in Israel which involved strict restrictions on movement and association with others, 280 adults aged 25–81 reported positive and negative qualities of their romantic relationship. Of these, 105 participants completed the survey again once lockdown restrictions were lifted. Contrary to our hypotheses, no evidence for age differences in the effect of the lockdown on positive or negative perceptions of relationship quality was detected. In addition, the lockdown did not influence participants' positive and negative perceptions of their romantic partners. However, we did find that, whereas people of all ages represent positive and negative qualities of their romantic partners as separate constructs, the negative association between the two is weaker for older adults compared to younger adults during (but not after) the lockdown. This finding suggests that in stressful times, older adults are better able to avoid negative perceptions clouding positive perceptions and see positive aspects of relationships with romantic partners in the face of negative ones. Findings extend evidence for age associations with complex emotional experiences to emotional aspects of interpersonal relationships. Findings enrich the theoretical understanding of age-related advantages in emotional well-being and may inform potential interventions for improving emotional health and well-being during times of crisis. [ABSTRACT FROM AUTHOR]

The article reports on the findings of a comparative case study of six projects that operated in Israel between 1980 and 2000. The study findings identify characteristics of the programs, the host organizations, and the social and political environment, which differentiated programs that are sustained from those that are not. The findings reaffirm the importance of the human factor, namely, the commitment of the leadership of the host organization. In addition, the findings of these case studies point to factors that until now have not gained sufficient attention, such as the type of host organization or public attitudes toward different target populations. (Contains 1 figure and 1 table.)

Nutritional counseling is a central part of eating disorder (ED) treatment. However, the nature of this treatment has not yet been described from women's perspectives. We conducted two studies exploring views of women regarding their ED nutritional counseling. In the first study, we used content analysis to reveal practices that registered dietitians (RDs) use in ED treatment. In the second study, we used phenomenological analysis to explore the nature of the client-dietitian collaboration. Data included 1,897 posts and 8,673 responses from 414 distinct female users, retrieved from a moderated ED Internet community website in Israel. Content analysis demonstrated six practices used by RDs: meal planning, weight monitoring, health assessment/consultation, establishing rapports, food logs, joint eating. Phenomenological analysis produced four positions demonstrating client-dietitian collaborations: "Silent dialogue," "Cancelation and deception," "Tough love," "Containment." Findings revealed women's efforts to continue treatment despite their ambivalence about goals and recovery, and RDs' efforts to help women, despite the women's ambivalence, to move forward toward recovery. [ABSTRACT FROM AUTHOR]

The aim of this research is to study young adults who try to lose weight using only healthful weight-control behaviors. Secondary analyses of the US National Longitudinal Study of Adolescent to Adult Health (Add-Health, N = 3,882) were performed. Females who used only healthful weight-control behaviors had lower self-esteem than females who did not try to lose weight, and less depressive symptoms than females who used unhealthful weight-control behaviors. Data suggested that females who used only healthful weight-control behaviors were at higher risk for gains in body mass index than females who did not try to lose weight. This study adds to the extant literature about weight-control behaviors by highlighting that people who try to lose weight using only healthful weight-control behaviors merit special attention from both scientific and practical points of view. [ABSTRACT FROM AUTHOR]

Objectives: Personality may constitute an important domain of influence on cognitive function in old-adults. We assessed the relationship of personality traits and cognitive performance in individuals with Type-2 Diabetes (T2D), and explored possible mediators. Method: The sample includes 377 dementia-free subjects with T2D participating in the Israel Diabetes and Cognitive Decline study who underwent assessment of cognition and personality (mean age 72 ± 4y; 42% females). We assessed the relationships of personality traits with episodic memory, semantic categorization, attention/working memory, executive function and overall cognition using linear regression models adjusting for age, education, sex, BMI, T2D duration, Hemoglobin A1C (HbA1C), hypertension, c-reactive protein, total- to HDL-cholesterol ratio and ApoEɛ4 genotype. A post-hoc mediation analysis was conducted with HbA1C, proportion of days covered (PDC) by T2D prescription claims and depressive symptoms. Results: After adjustment for multiple covariates, high neuroticism levels were associated with poorer performance overall (β= −0.16 ± 0.05; p = 0.001) and with poorer episodic memory, attention/working memory, and semantic categorization (β= −0.14 ± 0.05; p = 0.007, β= −0.12 ± 0.05; p = 0.017 and β= −0.12 ± 0.05; p = 0.018, respectively). High scores on openness to experience were associated with better global cognition (β = 0.11 ± 0.05; p = 0.026), executive functions (β = 0.13 ± 0.05; p = 0.013) and semantic categorization (β = 0.17 ± 0.05; p = 0.001, respectively). Depressive symptoms mediated the association of neuroticism with executive function, and the association of openness with executive function and overall cognition. Conclusion: Personality may play an important role in cognitive health among elderly subjects with T2D. Future studies should address the mechanisms underlying these relationships and specifically the potential role of depressive symptoms which may be in the causal pathway between personality traits and cognitive outcomes. [ABSTRACT FROM AUTHOR]

Objectives To investigate methods that older Holocaust survivors and their age peers use in order to maintain the best possible life and to examine associations between these methods and subjective well-being. Method Participants were 481 older Israelis (mean age 77.4 ± 6.7 years): Holocaust survivors (n = 164), postwar immigrants (n = 183), and prewar immigrants (n = 134). Measures included sociodemographics and indicators of health and well-being. Respondents were asked to answer an open-ended question: "What are the methods you use to maintain the best possible life?". Answers were coded into eight categories. Results Holocaust survivors were significantly less likely to mention methods coded as "Enjoyment" (32.3%) relative to postwar (43.7%) and prewar (46.2%) immigrants and significantly more likely to mention methods coded as "Maintaining good health" (39.0%) relative to postwar (27.9%) and prewar (21.6%) immigrants. Controlling for sociodemographics and health status, Holocaust survivors still differed from their peers. Discussion Aging Holocaust survivors tended to focus on more essential/fundamental needs (e.g. health), whereas their peers tended to focus on a wider range of needs (e.g. enjoyment) in their effort to maintain the best possible life. Our findings may add to the proactivity model of successful aging by suggesting that aging individuals in Israel use both proactive (e.g. health) and cognitive (e.g. accepting the present) adaptation methods, regardless of their reported history during the war. [ABSTRACT FROM AUTHOR]