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Objective We examined the psychometric properties of the Eating Disorder Readiness Ruler a simple self-report instrument designed to enable rapid assessment of readiness to change problematic eating behaviours in people with clinical eating disorders. Method We administered the ED-RR, the Eating Disorders Examination Questionnaire and a measure of autonomous and controlled motivation for change to 206 individuals receiving outpatient treatment for an eating disorder. Results A principal axis factoring analysis of the ED-RR yielded a significant two-factor solution (explaining 59% of variance)-one factor pertaining to restriction and body image preoccupation (four items), the other to binge-eating and vomiting symptoms (two items). The ED-RR showed good internal consistency (alpha coefficients for the two factors being .77 and .84 respectively). Furthermore, individuals reporting higher readiness showed higher scores on independent measures of autonomous motivation and greater symptom reductions over time. Discussion Results suggest that the ED-RR is a psychometrically sound tool with potential clinical utility. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Research associates maternal stress exposures (especially when occurring late in gestation) with heightened risk of subsequent emotional and behavioral problems in affected offspring. However, as yet, no study has examined the association between prenatal maternal stress (PNMS) and affected children's risk of anorexia- or bulimia-type eating disturbances. Objective To study the influences of PNMS on later disordered eating in exposed offspring. Method We used the Eating Attitudes Test (EAT)-26 to measure eating attitudes and behaviors in 54 thirteen-year olds whose mothers had been exposed, while pregnant with these children, to the 1998 Quebec Ice Storm-a natural disaster regarded as a model of exposure to severe environmental stress. Mothers' stress was measured shortly after exposure to the storm using established indices of objective and subjective stress. Results Hierarchical multiple linear regression analyses indicated that once variance owing to children's body mass index and sex was accounted for, stress exposures during the third trimester of pregnancy predicted elevated EAT-26 scores in affected children-perhaps even more so when levels of objective stress were high. Discussion Third trimester exposure to PNMS, especially when objectively severe, seems to be associated with increased eating-disorder-linked manifestations in affected early adolescents. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2015; 48:512-516) [ABSTRACT FROM AUTHOR]

Abstract: Stress and coping have been found to be strongly associated with quality of life (QOL). Compared to community controls (CC), individuals diagnosed with schizophrenia (SZ) report a lower QOL. Lower QOL in SZ may be explained by patients'' tendency to react differently to stress and to use less effective coping strategies than CC, but no studies to date have examined these possible associations. A main goal of this study, therefore, was to examine the roles of stress response and coping style in explaining QOL in SZ and CC, while controlling for potential confounds including personality. Subjects were 30 SZ patients and 29 matched controls who completed the Trier Social Stress Test (TSST). Salivary cortisol was used as an objective measure of stress response. Participants rated their coping strategies with the Brief COPE, judged their QOL with the Satisfaction with Life Scale, and rated their personality using the NEO-Five Factor Inventory. Results indicate that, even when confounds are controlled for, blunted cortisol response predicts better QOL in SZ patients. Additionally, results suggest that more frequent use of coping strategies is associated with better QOL but only in patients with blunted cortisol response; those who showed an increase in cortisol in response to the TSST have better QOL the lower their coping score. Possible explanations and clinical implications of these findings are discussed. [Copyright &y& Elsevier]

The purpose of this review is to summarize the current state of knowledge on how nongenetic factors occurring before, during, or soon after birth are related to schizophrenia. Schizophrenia is a complex psychiatric illness with a varied clinical presentation that has both environmental and genetic origins and that may result from insults to the nervous system that occur throughout development. In line with this, several endogenous (internal) and exogenous (external) nongenetic factors of pregnancy and birth have been related to an increased risk for schizophrenia in later life. These factors include maternal diabetes, low birth weight, older paternal age, winter birth, and prenatal maternal stress, among others. Although each of these nongenetic factors alone slightly increases the risk for schizophrenia, risk increases when these factors combine with each other and with other risk factors. The mechanisms that link each specific risk factor with the occurrence of schizophrenia remain largely unknown. In order to build better models of the illness, researchers will have to address the question of how environmental and genetic risk factors work together in increasing risk and explore to what extent certain underlying risk factors may explain different aspects of the disease. [ABSTRACT FROM AUTHOR]

Anhedonia is a negative prognostic indicator in schizophrenia. However, the underlying nature of this emotional deficit is unclear. Laboratory studies examining patients' emotional reactions under controlled circumstances have failed to find evidence for a diminished hedonic response, instead finding that patients' reactions to laboratory stimuli are characterised by high levels of negative emotion. The present study employed lexical analysis of natural speech in 52 patients and 49 non-patient controls while they discussed separate neutral, pleasant and unpleasant autobiographical memories. Patients with clinically rated anhedonia, versus other patients and controls, showed a dramatic increase in negative emotion expression when discussing pleasurable memories, but they showed no corresponding decrease in positive emotion. These findings provide further evidence that “anhedonia” is more reflective of negative emotional states than the absence of positive ones. These findings also raise questions about how positive and negative emotions can be simultaneously co-activated in patients with schizophrenia. [ABSTRACT FROM AUTHOR]

Introduction. Many recent studies have found that, although schizophrenia patients tend to display diminished facial expressions of emotion, they report levels of emotional experiences that are similar to those of controls. Although these findings are very informative, it is unknown whether such dissociation exits for other modalities such as verbal expression of emotion. The purpose of this study was to investigate the association between the use of emotion words during a free speech task and subjective experience of emotion in schizophrenia patients and controls. Methods. Speech samples of 48 schizophrenia patients and 48 nonpsychiatric control individuals were compared on the type and amount of emotional words used, as well as on the level of self-reported stress experienced while providing descriptions of themselves. Results. Groups did not differ in the amount or type of emotion words uttered during the free speech task. Patients, however, found the task more stressful than controls. Emotion word use and subjective emotional experience were not related in either group. Conclusions. Results do not fully support prior findings, but are consistent with the notion of a lack of correspondence between the expression and experience of emotion. [ABSTRACT FROM AUTHOR]

Abstract: Some studies have found that the speech of certain schizophrenia patients becomes more disordered in stressful laboratory situations. It is unknown, however, whether affective reactivity of speech is associated with stress responsiveness of symptoms in the real world. This study examines whether language-reactive patients report more stress-related impairments in work functioning than language-nonreactive patients. Forty-six patients provided speech samples and completed a work history interview. It was found that the language-reactive patients were more likely than the language-nonreactive patients to endorse items pertaining to social anxiety and difficulty relating to others as reasons for their work difficulties. This suggests that language-reactive patients are more sensitive to social stressors than language-nonreactive patients. [Copyright &y& Elsevier]

Unlabelled: Several studies have shown that patients with schizophrenia are more likely to be born in the winter and early spring than at any other time of the year. Furthermore, some studies have reported that winter-born patients differ from non-winter-born patients in terms of risk factors, symptoms, sensory abnormalities and brain morphology. Associations between season of birth and premorbid adjustment (PMA), however, are still unclear.Objective: The main purpose of this study was to determine whether winter-born and non-winter-born schizophrenia patients differ in terms of PMA and to examine how family history of schizophrenia-spectrum disorders may influence the association.Method: Data on four PMA dimensions (attention, internalizing, externalizing and social problems) and family history were gathered from 37 schizophrenia patients (26 males and 11 females) and their mothers.Results: Non-winter-birth and a positive family history of schizophrenia-spectrum disorders were associated with worse PMA. Results suggest that, although no significant interaction was found, season of birth and family history appear to work together in explaining distinct dimensions of PMA. [ABSTRACT FROM AUTHOR]

Objective: This report presents a French translation and validation of the Impact of Event Scale-Revised (IES-R) in a population of women exposed to a natural disaster during or preceding pregnancy.Method: A total of 223 francophone women who were either pregnant at the time of the 1998 ice storm or who became pregnant shortly thereafter completed the IES-R and other questionnaires 6 months after the disaster.Results: The French IES-R has good internal consistency, with alpha coefficients ranging from 0.81 to 0.93 for its 3 subscales and total score. The test-retest reliability of the scale, although examined with another sample, proved to be satisfactory, with correlation coefficients ranging from 0.71 to 0.76 for its 3 subscales and total score. Its convergent validity with perceived life threat and general psychiatric symptoms was judged to be marginally acceptable. Finally, a principal components analysis was conducted and a 3-factor solution, which explained 56% of the variance, was retained: a hyperarousal factor (7 items), an avoidance factor (6 items), and an intrusion factor (6 items).Conclusions: The French version of the IES-R has satisfactory internal validity and test-retest reliability. Further, the factor structure of the translation was similar to the proposed theoretical structure of the IES-R. [ABSTRACT FROM AUTHOR]

Objective: Although hospitalization is sometimes necessary when treating individuals with anorexia nervosa, the available literature provides limited guidance to inform decisions surrounding optimal components or duration of inpatient treatments. We report observational data comparing outcomes of two inpatient treatments. The first was longer and more strictly structured around a Contingency Management Protocol (CMP) emphasizing external incentives for achieving weight‐restoration goals; the second was a shorter Autonomy Support Protocol (ASP) that progressively increased patient autonomy around meal management without external incentives. Method: We compared data from 41 patients who participated in the ASP to a historical sample of 41 patients treated using the CMP. At admission, discharge, and post‐treatment follow‐up, participants completed the Eating Disorder Examination Questionnaire and the Behavior and Symptom Identification Scale‐32, and we measured height and weight to compute body mass index. Results: Multilevel modeling analyses that controlled for time in treatment and time in follow‐up indicated the two protocols yielded equivalent in‐treatment gains and post‐treatment loss of gains. Discussion: Our results indicate that shorter inpatient stays emphasizing autonomous control over eating behavior may yield outcomes that are equivalent to those of lengthier, more stringent, and more costly approaches implicating external incentives and controls. [ABSTRACT FROM AUTHOR]

Background: Given limited availability of informed treatments for people affected by eating disorders (EDs), there has been increasing interest in developing self-administered, technology-based ED interventions. However, many available interventions are limited to a specific ED diagnosis or assume that participants are ready to change. We developed a digital self-help application (called ASTrA) that was explicitly designed to be transdiagnostic and to help increase motivation for change. The aim of the present study was to describe the development and examine the psychometric properties, user satisfaction and rated potentials for practical use of our application. Methods: The content of our application was based on concepts derived from self-determination theory, the transtheoretical model of change, and cognitive theory. The application was developed by a multidisciplinary team of clinicians, researchers, staff members and individuals with lived ED experience, each being involved in all steps of the application's development. We tested validity, reliability, satisfaction and perceived feasibility for clinical implementation in an independent sample of 15 patients with an ED and 13 clinicians specialized in ED treatment. Psychometric properties were evaluated using descriptive statistics, correlations, content validity indices and intraclass coefficients. Differences in satisfaction ratings and perceived potential for clinical implementation of the application between clinicians and patients were examined using Mann–Whitney U tests. Results: The digital application showed excellent validity (mean i-CVI:.93, range:.86–.96) and internal reliability (all Cronbach alpha's >.88). Patients and clinicians both considered the application acceptable, appropriate, and feasible for use in clinical practice. Conclusions: Findings suggest that our transdiagnostic interactive application has excellent psychometric properties. Furthermore, patients and clinicians alike were positive about the possible use of the application in clinical practice. The next step will be to investigate the application's effectiveness as an intervention to promote autonomous motivation and to facilitate remission in people on the waitlist for specialized ED treatment. [ABSTRACT FROM AUTHOR]

Recent studies have reported altered methylation levels at disorder-relevant DNA sites in people who are ill with Anorexia Nervosa (AN) compared to findings in people with no eating disorder (ED) or in whom AN has remitted. The preceding implies state-related influences upon gene expression in people with AN. This study further examined this notion. We measured genome-wide DNA methylation in 145 women with active AN, 49 showing stable one-year remission of AN, and 64 with no ED. Comparisons revealed 205 differentially methylated sites between active and no ED groups, and 162 differentially methylated sites between active and remitted groups (Q < 0.01). Probes tended to map onto genes relevant to psychiatric, metabolic and immune functions. Notably, several of the genes identified here as being differentially methylated in people with AN (e.g. SYNJ2, PRKAG2, STAT3, CSGALNACT1, NEGR1, NR1H3) have figured in previous studies on AN. Effects also associated illness chronicity and lower BMI with more pronounced DNA methylation alterations, and remission of AN with normalisation of DNA methylation. Findings corroborate earlier results suggesting reversible DNA methylation alterations in AN, and point to particular genes at which epigenetic mechanisms may act to shape AN phenomenology. [ABSTRACT FROM AUTHOR]

Objective: Findings show virtual therapy (conducted using internet‐based videoconferencing techniques) to be a viable alternative to in‐person therapy for a variety of mental‐health problems. COVID‐19 social‐distancing imperatives required us to substitute virtual interventions for in‐person sessions routinely offered in our outpatient eating disorder (ED) program—and afforded us an opportunity to compare the two treatment formats for clinical efficacy. Methods: Using self‐report assessments, we compared outcomes in a historical sample of 49 adults with heterogeneous EDs (treated in‐person over 10–14 weeks in individual and group therapies) to those of 76 patients receiving comparable virtual treatments, at distance, during the COVID‐19 outbreak. Linear mixed models were used to study symptom changes over time and to test for differential effects of treatment modality. Results: Participants in both groups showed similar improvements on eating symptoms, levels of weight gain (in individuals in whom gain was indicated), and satisfaction with services. Discussion: Our results suggest that short‐term clinical outcomes with virtual and in‐person ED therapies are comparable, and point to potentials of virtual therapy for situations in which geographical distance or other barriers impede physical access to trained therapists or specialized treatments. [ABSTRACT FROM AUTHOR]

Background: This study explored state-related tendencies in DNA methylation in people with anorexia nervosa. Methods: We measured genome-wide DNA methylation in 75 women with active anorexia nervosa (active), 31 women showing stable remission of anorexia nervosa (remitted) and 41 women with no eating disorder (NED). We also obtained postintervention methylation data from 52 of the women from the active group. Results: Comparisons between members of the active and NED groups showed 58 differentially methylated sites (Q < 0.01) that corresponded to genes relevant to metabolic and nutritional status (lipid and glucose metabolism), psychiatric status (serotonin receptor activity) and immune function. Methylation levels in members of the remitted group differed from those in the active group on 265 probes that also involved sites associated with genes for serotonin and insulin activity, glucose metabolism and immunity. Intriguingly, the direction of methylation effects in remitted participants tended to be opposite to those seen in active participants. The chronicity of Illness correlated (usually inversely, at Q < 0.01) with methylation levels at 64 sites that mapped onto genes regulating glutamate and serotonin activity, insulin function and epigenetic age. In contrast, body mass index increases coincided (at Q < 0.05) with generally increased methylation-level changes at 73 probes associated with lipid and glucose metabolism, immune and inflammatory processes, and olfaction. Limitations: Sample sizes were modest for this type of inquiry, and findings may have been subject to uncontrolled effects of medication and substance use. Conclusion: Findings point to the possibility of reversible epigenetic alterations in anorexia nervosa, and suggest that an adequate pathophysiological model would likely need to include psychiatric, metabolic and immune components. [ABSTRACT FROM AUTHOR]

Theory of mind (ToM) is an aspect of social cognition that refers to the ability to make inferences about the thoughts, feelings, and intentions of other people. It is believed to be related to social functioning. Previous investigations of ToM in schizotypy have yielded mixed results. Using a correlational approach, the present study explored the relationship between schizotypal traits, ToM, neurocognition, depressed mood, and social functioning in a sample of 50 undergraduate students. Schizotypy was related to poor social functioning. Contrary to predictions, schizotypal traits were not associated with impaired ToM. In fact, schizotypal traits were associated with enhanced performance on a ToM task that involved detection of ironic statements. However, strong relationships emerged among schizotypy, depressed mood, and social functioning, highlighting the need to also examine depression when assessing the relations between elevated schizotypy and poor social functioning. [ABSTRACT FROM AUTHOR]

Objetivo: Cabría esperar que las alteraciones del lenguaje asociadas con la esquizofrenia tuvieran un intenso impacto sobre la capacidad de producir un discurso coherente, pero las asociaciones entre el rendimiento cognitivo y los trastornos del lenguaje han sido habitualmente débiles. Es posible que hallazgos al respecto hayan estado limitados por los métodos de medición y por la heterogeneidad del trastorno del lenguaje. Este estudio examinó las contribuciones de las alteraciones del mantenimiento de la atención y de la capacidad de secuenciación en el trastorno esquizofrénico del lenguaje, medido en cuanto a fallos de la comunicación y dividido en diferentes tipos de trastorno. Método: Se recopilaron muestras de habla natural de pacientes institucionalizados gravemente enfermos y de individuos no psiquiátricos de comparación, y se evaluó la frecuencia de seis tipos de fallos de comunicación: cuatro tipos estructurales y dos no estructurales. Los individuos también completaron una batería de pruebas cognitivas que evaluaban varias facetas de la atención y de la capacidad de secuenciación. Se empleó la regresión jerárquica para identificar los contribuyentes cognitivos a los fallos de comunicación. Resultados: El déficit del mantenimiento de la atención se asoció con una mayor frecuencia de fallos estructurales de comunicación. Como se había pronosticado, el déficit de la secuenciación y, especialmente, de la secuenciación conceptual, también tuvo una contribución fundamental a los fallos estructurales de la comunicación, pero no a los no estructurales. Estos resultados se mantuvieron cuando se controló estadísticamente el grado global de alteración. Los resultados de las pruebas de atención y de secuenciación explicaron el 56 % de la varianza del trastorno estructural del lenguaje. Conclusiones: El trastorno esquizofrénico del lenguaje es heterogéneo en su forma y en sus fundamentos cognitivos. Los déficit de atención y de las capacidades de secuenciación pronostican en gran medida los fallos de comunicación relacionados con la estructura del lenguaje. [ABSTRACT FROM AUTHOR]

Objective: Cognitive impairments associated with schizophrenia might be expected to have a marked impact on the ability to produce coherent speech, yet associations between cognitive performance and speech disorder have typically been weak. Findings on this question may have been limited by measurement methods and by the heterogeneity of speech disorder. This study examined the contributions of impairments in sustained attention and sequencing abilities to schizophrenic speech disorder, measured in terms of communication failures and divided into different types of disorder. Method: Samples of natural speech were collected from severely ill inpatients with schizophrenia and nonpsychiatric comparison subjects and rated for frequencies of six types of communication failures: four structural and two nonstructural types. Subjects also completed a battery of cognitive tests assessing several facets of attention and sequencing ability. Hierarchical regression was used to identify cognitive contributors to communication failures. Results: Impaired sustained attention was associated with more frequent structural and nonstructural communication failures. As predicted, impaired sequencing, and in particular conceptual sequencing, also made a substantial contribution to the structural communication failures, but not to the nonstructural ones. These findings held when global level of impairment was controlled statistically. Performance on the tests of attention and sequencing explained 56% of the variance in structural speech disorder. Conclusions: Schizophrenic speech disorder is heterogeneous in form and in cognitive underpinnings. Impairments in attention and sequencing abilities are highly predictive of communication failures related to language structure. [ABSTRACT FROM AUTHOR]