Joseph A. Wonderlich

The impact of the 2009 Red River Flood on interpersonal risk factors for suicide.

BACKGROUND Natural disasters are frequently associated with increases in risk factors for suicide, yet research indicates that suicide rates tend to stay the same or decrease in the wake of disasters (e.g., Krug et al., 1999). AIMS The present research sought to shed light on this counterintuitive phenomenon by testing hypotheses derived from Joiners (2005) interpersonal-psychological theory of suicidal behavior, which proposes that the desire to die by suicide is the result of feeling like one does not belong and feeling like one is a burden on others. During natural disasters, community members often pull together in volunteering efforts, and it was predicted that such behaviors would boost feelings of belonging and reduce feelings that one is a burden. METHODS The present study tested these predictions in a sample of 210 undergraduate students in Fargo, North Dakota, following the 2009 Red River Flood. RESULTS Consistent with prediction, greater amounts of time spent volunteering in flood efforts were associated with increased feelings of belongingness and decreased feelings of burdensomeness. CONCLUSIONS The findings in the current study are consistent with the notion that communities pulling together during a natural disaster can reduce interpersonal risk factors associated with the desire for suicide.

Growth hormone signaling is necessary for lifespan extension by dietary methionine

Growth hormone significantly impacts lifespan in mammals. Mouse longevity is extended when growth hormone (GH) signaling is interrupted but markedly shortened with high‐plasma hormone levels. Methionine metabolism is enhanced in growth hormone deficiency, for example, in the Ames dwarf, but suppressed in GH transgenic mice. Methionine intake affects also lifespan, and thus, GH mutant mice and respective wild‐type littermates were fed 0.16%, 0.43%, or 1.3% methionine to evaluate the interaction between hormone status and methionine. All wild‐type and GH transgenic mice lived longer when fed 0.16% methionine but not when fed higher levels. In contrast, animals without growth hormone signaling due to hormone deficiency or resistance did not respond to altered levels of methionine in terms of lifespan, body weight, or food consumption. Taken together, our results suggest that the presence of growth hormone is necessary to sense dietary methionine changes, thus strongly linking growth and lifespan to amino acid availability.

Restrictive eating behaviors are a nonweight-based marker of severity in anorexia nervosa.

OBJECTIVE The purpose of this study was to compare the type and frequency of restrictive eating behaviors across the two subtypes of anorexia nervosa (AN; restricting [ANr] and binge eating/purging [ANbp]) using ecological momentary assessment (EMA) and to determine whether subtype differences in restrictive eating behaviors were attributable to severity of the disorder or the frequency of binge eating. METHOD Participants (N = 118) were women at least 18 years of age with full (n = 59) or subthreshold (n = 59) AN who participated in a two week (EMA) protocol. RESULTS General estimating equations revealed that individuals with ANbp generally reported more frequent restrictive eating behaviors than individuals with ANr. These differences were mostly accounted for by greater severity of eating psychopathology, indicating that the presence and frequency of restrictive eating behaviors in AN may be nonweight-based markers of severity. Binge eating frequency did not account for these findings. DISCUSSION The present findings are especially interesting in light of the weight-based severity rating in the DSM-5.

Examining convergence of retrospective and ecological momentary assessment measures of negative affect and eating disorder behaviors

OBJECTIVE Data gathered via retrospective forms of assessment are subject to various recall biases. Ecological momentary assessment (EMA) is an alternative approach involving repeated momentary assessments within a participants natural environment, thus reducing recall biases and improving ecological validity. EMA has been used in numerous prior studies examining various constructs of theoretical relevance to eating disorders. METHOD This investigation includes data from three previously published studies with distinct clinical samples: (a) women with anorexia nervosa (N = 118), (b) women with bulimia nervosa (N = 133), and (c) obese men and women (N = 50; 9 with current binge eating disorder). Each study assessed negative affective states and eating disorder behaviors using traditional retrospective assessments and EMA. Spearman rho correlations were used to evaluate the concordance of retrospective versus EMA measures of affective and/or behavioral constructs in each sample. Bland-Altman plots were also used to further evaluate concordance in the assessment of eating disorder behaviors. RESULTS There was moderate to strong concordance for the measures of negative affective states across all three studies. Moderate to strong concordance was also found for the measures of binge eating and exercise frequency. The strongest evidence of concordance across measurement approaches was found for purging behaviors. DISCUSSION Overall, these preliminary findings support the convergence of retrospective and EMA assessments of both negative affective states and various eating disorder behaviors. Given the advantages and disadvantages associated with each of these assessment approaches, the specific questions being studied in future empirical studies should inform decisions regarding selection of the most appropriate method.

Impact of the neural correlates of stress and cue reactivity on stress related binge eating in the natural environment

Women with symptoms of bulimia nervosa (BN) exhibit decreased response to visual food cues in several limbic and frontal regions compared to controls. Stress causes decreased blood oxygenation level dependent (BOLD) response in these regions in non-clinical samples; there is a lack of data on this topic in BN. This study examined the impact of individual differences in neural reactivity to palatable food cues following acute stress on stress-binge trajectories in everyday life. 16 women with BN symptoms viewed palatable food cues prior to and immediately following an acute stress induction in the scanner. Participants then responded to a series of prompts assessing daily ratings of stress and binge episodes for a period of two weeks. Decreased BOLD signal was observed in response to food cues pre to post stress in the anterior cingulate cortex (ACC), amygdala, and ventromedial prefrontal cortex (vmPFC). Ecological momentary assessment data collection demonstrated that stress increased prior to binge episodes in the natural environment, and decreased following. Changes in activation in the ACC, precuneus, and dorsolateral prefrontal cortex (dlPFC) significantly moderated the relationship of stress to binge eating in daily life, such that women who exhibited decreased response reported significantly increasing stress prior to binges, while women who did not exhibit decreases reported no significant change in stress prior to binges. Individual differences in neural response to food cues under stress appear to underlie distinct antecedants to binge eating.

The Contributing Role of Bile Acids to Metabolic Improvements After Obesity and Metabolic Surgery

Obesity and metabolic surgery (OMS) leads to several metabolic improvements, which often occur prior to substantial weight loss. Therefore, other factors in addition to weight loss contribute to the metabolic benefits. This literature review offers an overview of studies investigating bile acids (BAs) and their metabolic effects after OMS. Rearrangement of enterohepatic circulation, changes in BA synthesis, BA conjugation, intestinal reabsorption, and alterations in the gut microbiota are potential mechanisms for altered BA profiles after surgery. Increased BA levels are associated with improved glucose homeostasis and lipid profiles, which are mediated by two major receptors: the Transmembrane G-protein Coupled Receptor and the Farnesoid X Receptor. Therefore, pharmacological manipulation of BAs and their receptors may be viable targets for less invasive obesity treatment.

Comparison of Warfarin Dosages and International Normalized Ratios Before and After Roux-en-Y Gastric Bypass Surgery.

As data are limited for dosing warfarin in patients who have undergone bariatric surgery, our objective was to gather data on warfarin pharmacotherapy to aid in the prescribing practices and dosage adjustment of warfarin after Roux‐en‐Y gastric bypass (RYGB) surgery.

Using bivariate latent basis growth curve analysis to better understand treatment outcome in youth with anorexia nervosa

OBJECTIVE This study explored the relation between eating-related obsessionality and weight restoration utilizing bivariate latent basis growth curve modelling. Eating-related obsessionality is a moderator of treatment outcome for adolescents with anorexia nervosa (AN). This study examined the degree to which the rate of change in eating-related obsessionality was associated with the rate of change in weight over time in family-based treatment (FBT) and individual therapy for AN. METHOD Data were drawn from a 2-site randomized controlled trial that compared FBT and adolescent focused therapy for AN. Bivariate latent basis growth curves were used to examine the differences of the relations between trajectories of body weight and symptoms associated with eating and weight obsessionality. RESULTS In the FBT group, the slope of eating-related obsessionality scores and the slope of weight were significantly (negatively) correlated. This finding indicates that a decrease in overall eating-relating obsessionality is significantly associated with an increase in weight for individuals who received FBT. However, there was no relation between change in obsessionality scores and change in weight in the adolescent focused therapy group. DISCUSSION Results suggest that FBT has a specific impact on both weight gain and obsessive compulsive behaviour that is distinct from individual therapy.

Negative urgency and expectancies increase vulnerability to binge eating in bulimia nervosa

ABSTRACT Negative urgency (NU), the tendency to act impulsively when distressed, is associated with binge eating. Women who believe that eating alleviates negative affect are also more likely to binge eat. Thus, it is hypothesized that the individuals with high levels of NU, and who endorse these eating expectancies, will binge eat the following acute distress. This study tested these hypotheses using ecological momentary assessment. Sixteen women with the symptoms of BN completed clinical assessments, and were asked to report on distress and binges multiple times daily for two weeks. NU moderated the temporal relationship of negative affect to binges, such that women with lower scores on NU experienced a sharper increase in affect prior to binges. Individual differences in eating expectancies also moderated the relationship of affect to binge eating. Results suggest that women with high levels of NU and expectancy endorsement are triggered to binge by smaller shifts in negative affect than women who do not endorse these traits.

Impulsivity, Stress Reactivity, and Eating Disorders

Abstract Negative urgency (NU) is the tendency to act rashly while distressed. Binge eating, the consumption of a large amount of food with associated loss of control, is often triggered by increases in negative affect. NU has strong associations with binge eating in nonclinical samples, predicts the onset of binge eating in youth, predicts increases in binge eating over time, and interacts with shifts in negative affect to predict binge eating in daily life in women with eating disorders. Outcome expectancy endorsement differentiates specific impulsive behavioral choices among those with high NU. These expectancies may represent a prepotent response that is made more salient by shifts in negative affect. Recent research indicates that activation in response to appetitive or emotional cues in the prefrontal cortex is associated with urgency. These studies suggest that the neurobiological underpinnings of this trait may be linked to taxed inhibitory control.