Brunna Tuschen-Caffier

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 ...

Emotion Regulation and Vulnerability to Depression: Spontaneous Versus Instructed Use of Emotion Suppression and Reappraisal

Emotion dysregulation has long been thought to be a vulnerability factor for mood disorders. However, there have been few empirical tests of this idea. In this study, we tested the hypothesis that depression vulnerability is related to difficulties with emotion regulation by comparing recovered-depressed and never-depressed participants (N = 73). In the first phase, participants completed questionnaires assessing their typical use of emotion regulation strategies. In the second phase, sad mood was induced using a film clip, and the degree to which participants reported to have spontaneously used suppression versus reappraisal to regulate their emotions was assessed. In the third phase, participants received either suppression or reappraisal instructions prior to watching a second sadness-inducing film. As predicted, suppression was found to be ineffective for down-regulating negative emotions, and recovered-depressed participants reported to have spontaneously used this strategy during the first sadness-inducing film more often than controls. However, the groups did not differ regarding the effects of induced suppression versus reappraisal on negative mood. These results provide evidence for a role for spontaneous but not instructed emotion regulation in depression vulnerability.

Meta‐analysis of the effectiveness of psychological and pharmacological treatments for binge eating disorder

OBJECTIVE The aim of this study was to compute and compare mean effects of various treatments for binge eating disorder. METHOD A total of 38 studies with 1973 participants fulfilled the defined inclusion criteria. Effect sizes, odds ratios, and simple rates were integrated in fixed and random (mixed) effects categorical models. RESULTS From randomized controlled trials, psychotherapy and structured self-help, both based on cognitive behavioral interventions, were found to have large effects on the reduction of binge eating. Regarding pharmacotherapy, mainly comprising antidepressants, randomized controlled trials revealed medium effects for the reduction of binge eating. Uncontrolled studies on weight-loss treatments demonstrated moderate reductions of binge eating. Combination treatments did not result in higher effects compared with single-treatment regimens. Except for weight-loss treatment, none of the interventions resulted in a considerable weight reduction. DISCUSSION Psychotherapy and structured self-help, both based on cognitive-behavioral interventions, should be recommended as the first-line treatments.

Emotion regulation deficits in eating disorders: a marker of eating pathology or general psychopathology?

Preliminary evidence indicates that individuals with eating disorders (ED) show emotion regulation (ER) difficulties. However, it is yet unclear whether different types of ED differ in their ER profile and whether certain ER difficulties are specific for ED or rather a transdiagnostic factor. Twenty women with anorexia nervosa (AN), 18 with bulimia nervosa (BN), 25 with binge eating disorder (BED), 15 with borderline personality disorder (BPD), 16 with major depressive disorder (MDD) and 42 female healthy controls (HC) were administered the Emotion Regulation Questionnaire, the Inventory of Cognitive Affect Regulation Strategies, the Difficulties in Emotion Regulation Scale and the Affect Intensity Measure. The ED groups reported significantly higher levels of emotion intensity, lower acceptance of emotions, less emotional awareness and clarity, more self-reported ER problems as well as decreased use of functional and increased use of dysfunctional emotion regulation strategies when compared to HC. No significant differences between the ED groups emerged for most ER variables. However, there were indications that the BED group may show a slightly more adaptive pattern of ER than the two other ED groups. As a whole, all clinical groups performed very similar on most ER variables and reported more difficulties regulating their emotions than HC. The findings suggest that ER difficulties are not linked to a particular diagnostic category. Instead, ER difficulties appear to be a transdiagnostic risk and/or maintenance factor rather than being disorder-specific.

Emotion recognition deficits in body dysmorphic disorder

Patients with Body Dysmorphic Disorder (BDD) are characterized by excessive concerns about imagined defects in their appearance, most commonly, facial features. In this study, we investigated (1) the ability to identify facial expressions of emotion, and (2) to discriminate single facial features in BDD patients, Obsessive-Compulsive Disorder (OCD) patients, and in healthy control participants. Specifically, their ability for general facial feature discrimination was assessed using the Short Form of the Benton Facial Recognition Test (Benton AL, Hamsher KdeS, Varney NR, Spreen O. Contributions to neuropsychological assessment: a clinical manual. New York: Oxford University Press; 1983). However, findings of the BFRT indicate no differences among the groups. Moreover, participants were presented with facial photographs from the Ekman and Friesen (Ekman P, Friesen W. Unmasking the face: a guide to recognizing emotions from facial cues. Englewood Cliffs, NJ: Prentice-Hall; 1975 and Ekman P, Friesen W. Pictures of facial affect. Palo Alto: Consulting Psychologists Press, 1976) series and were asked to identify the corresponding emotion. The BDD group was less accurate than the control group, but not the OCD group, in identifying facial expressions of emotion. Relative to the control and OCD groups, the BDD group more often misidentified emotional expressions as angry. In contrast to the findings of Sprengelmeyer et al. [Proc. Royal Soc. London Series B: Biol. Sci. 264 (1997),1767], OCD patients did not show a disgust recognition deficit. Poor insight and ideas of reference, common in BDD, might partly result from an emotion recognition bias for angry expressions. Perceiving others as angry and rejecting might reinforce concerns about ones personal ugliness and social desirability.

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...

Decision-making impairments in women with binge eating disorder.

Even though eating is frequently driven by overindulgence and reward rather than by energy balance, few studies so far have analyzed decision-making processes and disturbances in feedback processing in women with binge eating disorder (BED). In an experimental study, 17 women with BED (DSM-IV) and 18 overweight healthy controls (HC) were compared in the game of dice task (GDT). This task assesses decision-making under risk with explicit rules for gains and losses. Additionally, differences in dispositional activation of the behavior inhibition and behavior approach system as well as cognitive flexibility were measured. Main results revealed that women with BED make risky decisions significantly more often than HC. Moreover, they show impaired capacities to advantageously utilize feedback processing. Even though these deficits were not related to disease-specific variables, they may be important for the daily decision-making behavior of women with BED, thus being relevant as a maintenance factor for the disorder.

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.

Interpretive biases for ambiguous information in body dysmorphic disorder.

Anxiety-disordered patients and individuals with high trait anxiety tend to interpret ambiguous information as threatening. The purpose of this study was to investigate whether interpretive biases would also occur in body dysmorphic disorder (BDD), which is characterized by a preoccupation with imagined defects in ones appearance. We tested whether BDD participants, compared with obsessive-compulsive disorder participants and healthy controls, would choose threatening interpretations for ambiguous body-related, ambiguous social, and general scenarios. As we hypothesized, BDD participants exhibited a negative interpretive bias for body-related scenarios and for social scenarios, whereas the other groups did not. Moreover, both clinical groups exhibited a negative interpretive bias for general scenarios.

Psychological and Physiological Reactivity to Stress: An Experimental Study on Bulimic Patients, Restrained Eaters and Controls

Background: Binge eating behavior in bulimic patients is thought to play a crucial role in the regulation of psychophysiological arousal in stressful situations. Previous results suggest that interpersonal stress and achievement challenge are perceived as particularly stressful by bulimic individuals. It is not clear, however, whether bulimic individuals respond to stress with an increased desire to binge, and whether this increase is accompanied by higher psychophysiological reactivity compared to healthy controls. Methods: Twenty-seven patients with bulimia nervosa (DSM-IV), 27 restrained eaters, and 27 controls participated in two experimental sessions in which continuous measures of heart rate, blood pressure, respiration rate, and electrodermal activity were monitored under conditions of achievement challenge (mental arithmetic, Stroop test) and interpersonal stress provoking feelings of loneliness and social rejection (film, imagery task). Ratings of desire to binge, negative mood, and hunger were obtained between experimental trials. Groups were matched for age and body mass index. Results: There was a marked difference in subjective ratings during interpersonal stress. Bulimic patients responded to the imagery task with increases in both desire to binge and hunger, whereas restrained eaters and controls showed no change. There were no substantial group differences in psychophysiological reactivity. Conclusions: The dissociation between emotional responses and physiological activation may have important therapeutic implications.