Anja Hilbert

Eating Disorder Examination-Questionnaire

Zusammenfassung. Der Eating Disorder Examination-Questionnaire von Fairburn und Beglin (EDE-Q; 1994) ist die Fragebogenversion des strukturierten Essstorungsinterviews Eating Disorder Examination (EDE). Der EDE-Q erfasst die spezifische Essstorungspsychopathologie mithilfe von vier Subskalen zum gezugelten Essverhalten, zu Sorgen uber das Essen, Gewicht und Figur. Die in diesem Beitrag vorgestellte deutschsprachige Ubersetzung des EDE-Q wurde in Stichproben mit Anorexia nervosa, Bulimia nervosa und atypischen Essstorungen, sowie nicht-klinischen, subklinischen und psychiatrischen Vergleichsgruppen teststatistisch untersucht (N = 706). Der EDE-Q erwies sich als intern konsistent und stabil. Seine faktorielle Struktur wurde teilweise reproduziert. Die Kennwerte des EDE-Q waren signifikant mit denen des EDE korreliert, fielen erwartungsgemas jedoch teilweise hoher aus. Weitere Hinweise fur die konvergente Validitat ergaben sich durch Korrelationen mit konzeptverwandten Fragebogen. Der EDE-Q zeigte eine gute ...

Eating Disorder Examination: Deutschsprachige Version des strukturierten Essstörungsinterviews

Zusammenfassung. Das Eating Disorder Examination (EDE) von Fairburn und Cooper (1993) ist ein strukturiertes Essstorungsinterview zur Erfassung der spezifischen Psychopathologie von Essstorungen. In der klinischen Forschung und Praxis gilt es weithin als Methode der Wahl fur die Essstorungsdiagnostik. Die in diesem Beitrag vorgestellte deutschsprachige, reubersetzte Version des EDE zeigte in Stichproben von 80 Patientinnen mit Bulimia Nervosa, 144 Patientinnen mit Binge-Eating-Storung und 20 Patientinnen mit Anorexia Nervosa hohe Interrater-Reliabilitaten der Items sowie der Subskalen. Als Indikatoren fur die konvergente Validitat waren die EDE-Subskalen Shape Concern und Weight Concern mit Selbstbeurteilungsskalen zum Korperbild, z.B. dem Fragebogen zum Figurbewusstsein, hoch korreliert. Die EDE-Subskalen Restraint und Eating Concern zeigten signifikante Zusammenhange mit dem in Ernahrungstagebuchern protokollierten Essverhalten, z.B. Mahlzeiten- oder Essanfallshaufigkeit oder Nahrstoffaufnahme. Die Subs...

How frequent are eating disturbances in the population? Norms of the eating disorder examination-questionnaire.

Objective The Eating Disorder Examination-Questionnaire (EDE-Q) is a self-report instrument assessing the specific psychopathology and key behaviors of eating disorders. This study sought to determine the prevalence of eating disturbances, and to provide psychometric properties and norms of the EDE-Q, in a representative German population sample. Methods A total of 2520 individuals (1166 men, 1354 women) were assessed with the EDE-Q. Results Eating disorder psychopathology was higher and most key behaviors were more prevalent in women than in men. Psychopathology declined with age ≥65 in both sexes, and showed a peak at age 55–64 in men. Overall, 5.9% of the women and 1.5% of the men revealed eating disturbances. The prevalence of eating disturbances decreased with age in women and was significantly higher in obese than in normal-weight individuals. Psychometric analyses showed favorable item characteristics. Internal consistencies of EDE-Q composite scores were ≥.80 for women and ≥.70 for men. The factor structure of the EDE-Q was partially reproduced. Sex- and age-specific population norms are reported. Discussion This study provides population norms of the EDE-Q for both sexes and across the age range, demonstrates demographic variations in symptomatology, and reveals satisfactory psychometric properties. Further research is warranted on eating disturbances in older adults.

Emotion regulation and binge eating in children

OBJECTIVE To examine the ability to regulate emotions in children with binge eating. METHOD A community sample of 60 children ages 8-13 with at least one episode of loss of control (LOC) eating during the past 3 months and a matched control group without LOC (n = 60) underwent a clinical interview (Eating Disorder Examination adapted for Children) and completed self-report questionnaires assessing emotion regulation strategies, eating pathology, and depressive symptoms. RESULTS Children with LOC eating made a significantly higher use of dysfunctional emotion regulation strategies (p < .01), especially for the regulation of anxiety (p < .01). Maladaptive strategies were associated with greater depressiveness (p < .001). Use of adaptive emotion regulation strategies did not differ between children with and without LOC eating. DISCUSSION Results document an association between LOC eating and difficulties in regulating negative emotions in children. Interventions targeting LOC eating in children should include training for coping with negative emotions.

Stigmatizing Attitudes Toward Obesity in a Representative Population-based Sample

Objective: The aim of this study was to determine stigmatizing attitudes toward obesity in the population, and its related psychological and sociodemographic determinants.

Effects of prolonged and repeated body image exposure in binge-eating disorder.

OBJECTIVE The purpose of the present study was to investigate psychological mechanisms associated with prolonged and repeated body image exposure. METHOD In an experimental design, 30 female volunteers diagnosed with binge-eating disorder (BED) (DSM-IV) and 30 non-eating-disordered controls (NC) were exposed to their physical appearance in a mirror. The confrontation procedure was guided by a standardized interview manual and took place on two separate days. Self-reported mood, appearance self-esteem, and frequency of negative cognitions were assessed repeatedly throughout the experiment. RESULTS During body image exposure sessions, binge-eating-disordered individuals showed significantly lower mood than controls while appearance self-esteem was diminished in both groups. During the second body image exposure session, higher levels of mood and appearance self-esteem were observed in both groups, and negative cognitions occurred less frequently. CONCLUSION Results are discussed with regard to the therapeutic use of body image exposure.

Psychological responses to body shape exposure in patients with bulimia nervosa.

One of the unresolved issues regarding research on bulimia nervosa concerns the question as to how patients diagnosed with bulimia nervosa respond to body image exposure. In addition, it remains unclear whether there are differential responses associated with different exposure techniques (e.g. in vivo exposure vs. exposure by visualization). The aim of the present study was to investigate psychological responses to body image exposure. Twenty participants diagnosed with bulimia nervosa (DSM IV) and twenty non-eating disordered individuals were exposed to their body image using a video recording (video confrontation). In addition, they were asked to imagine and describe the appearance of their body (imagery task). Results indicate that self-reported negative emotions increased in response to both, video confrontation and imagery task, in the clinical as well as in the control group. Furthermore, video confrontation led to more pronounced group differences than exposure by visualization (imagery task). Participants diagnosed with bulimia nervosa took less time to describe their waist, hips and bottom compared to non-eating disturbed controls. This last result could be interpreted in terms of avoidance behavior and other mechanisms during body image exposure.

Long-term efficacy of psychological treatments for binge eating disorder

BACKGROUND The long-term efficacy of psychological treatments for binge eating disorder remains largely unknown. AIMS To examine the long-term efficacy of out-patient group cognitive-behavioural therapy (CBT) and group interpersonal psychotherapy (IPT) for binge eating disorder and to analyse predictors of long-term non-response. METHOD Ninety people with binge eating disorder were assessed 4 years after treatment cessation within a randomised trial (trial registration: NCT01208272). RESULTS Participants showed substantial long-term recovery, partial remission, clinically significant improvement and significant reductions in associated psychopathology, despite relapse tendencies in single secondary outcomes. Body mass index remained stable. While the IPT group demonstrated an improvement in eating disorder symptoms over the follow-up period, the CBT group reported a worsening of symptoms, but treatments did not differ at any time point. CONCLUSIONS The results document the long-term efficacy of out-patient CBT and IPT for binge eating disorder. Further research is warranted to elucidate the time course and mechanisms of change of these treatments for binge eating disorder.

Toward an understanding of risk factors for Anorexia Nervosa: A case-control study

BACKGROUND Prospective, longitudinal studies of risk factors for anorexia nervosa (AN) are lacking and existing cross-sectional studies are generally narrow in focus and lack methodological rigor. Building on two studies that used the Oxford Risk Factor Interview (RFI) to establish time precedence and comprehensively assess potential risk correlates for AN, the present study advances this line of research and represents the first case-control study of risk factors for AN in the USA. METHOD The RFI was used for retrospective assessment of a broad range of risk factors, while establishing time precedence. Using a case-control design, 50 women who met DSM-IV criteria for AN were compared to those with non-eating disorder DSM-IV psychiatric disorders (n=50) and those with no psychiatric disorder (n=50). RESULTS Women with psychiatric disorders reported higher rates of negative affectivity, maternal and paternal parenting problems, family discord, parental mood and substance disorder, and physical and sexual abuse than women with no psychiatric disorder. Women with AN specifically reported greater severity and significantly higher rates of negative affectivity, perfectionism and family discord, and higher parental demands than women with other psychiatric disorders. The role of weight and shape concerns was most salient in the year preceding onset of AN. CONCLUSIONS Convergent data identifying common risk factors as well as those more severe in the development of AN are emerging to inform longitudinal risk factor and prevention studies for this disorder.

Pretreatment and process predictors of outcome in interpersonal and cognitive behavioral psychotherapy for binge eating disorder.

The present study examined pretreatment and process predictors of individual nonresponse to psychological group treatment of binge eating disorder (BED). In a randomized trial, 162 overweight patients with BED were treated with either group cognitive-behavioral therapy or group interpersonal psychotherapy. Treatment nonresponse, which was defined as nonabstinence from binge eating, was assessed at posttreatment and at 1 year following treatment completion. Using 4 signal detection analyses, greater extent of interpersonal problems prior to treatment or at midtreatment were identified as predictors of nonresponse, both at posttreatment and at 1-year follow-up. Greater pretreatment and midtreatment concerns about shape and weight, among those patients with low interpersonal problems, were predictive of posttreatment nonresponse. Lower group cohesion during the early treatment phase predicted nonresponse at 1-year follow-up. Attention to specific pre- or intreatment predictors could allow for targeted selection into differential or augmented care and could thus improve response to group psychotherapy for BED.