Objective Internet‐based guided self‐help (GSH) programs increase accessibility and utilization of evidence‐based treatments in binge‐eating disorder (BED). We evaluated acceptance and short as well as long‐term efficacy of our 8‐session internet‐based GSH program in a randomized clinical trial with an immediate treatment group, and two waitlist control groups, which differed with respect to whether patients received positive expectation induction during waiting or not. Method Sixty‐three patients (87% female, mean age 37.2 years) followed the eight‐session guided cognitive‐behavioural internet‐based program and three booster sessions in a randomized clinical trial design including an immediate treatment and two waitlist control conditions. Outcomes were treatment acceptance, number of weekly binge‐eating episodes, eating disorder pathology, depressiveness, and level of psychosocial functioning. Results Treatment satisfaction was high, even though 27% of all patients dropped out during the active treatment and 9.5% during the follow‐up period of 6 months. The treatment, in contrast to the waiting conditions, led to a significant reduction of weekly binge‐eating episodes from 3.4 to 1.7 with no apparent rebound effect during follow‐up. All other outcomes improved as well during active treatment. Email‐based positive expectation induction during waiting period prior to the treatment did not have an additional beneficial effect on the temporal course and thus treatment success, of binge episodes in this study. Conclusion This short internet‐based program was clearly accepted and highly effective regarding core features of BED. Dropout rates were higher in the active and lower in the follow‐up period. Positive expectations did not have an impact on treatment effects.
Vivid imagination of thin ideals promoted by magazines results in impaired mood and BIS and moreover in body-related cognitive distortions (TSF-B) in healthy women, especially, for those with stronger ED symptomatology.
Comprehensive models, targeting the development of eating disorders (EDs) in males, often employ a sociocultural perspective and empathize the importance of body dissatisfaction (BD). To further illuminate psychological factors contributing to the development of ED pathology, we propose a mediator model of disturbed eating and compensatory behavior (DECB) for men. This model suggests that emotion dysregulation and the susceptibility to body-related cognitive distortions (thought-shape fusion, TSF) mediate the relationship between BD and DECB. Based on data from a cross-sectional online-survey we tested our model in a non-clinical community sample of young men (N=123, 18-37 years). We found a significant positive association between BD and DECB, accounting for participant's body mass index (BMI), age and depressive symptoms. While TSF partially mediated the relationship between BD and DECB, we did not detect a corresponding effect for emotion dysregulation. Based on our findings, we concluded that TSF, which describes specific distorted cognitions with respect to one's own body triggered by fattening/ forbidden food, contributes to the pathological eating- and body-related behavior in men who are dissatisfied with their body. We suggest that TSF should be included in etiological models as a relevant aspect of cognitive information processing with emotional and behavioral consequences.
OBJECTIVE: Impairments in facial emotion recognition are an underlying factor of deficits in emotion regulation and interpersonal difficulties in mental disorders and are evident in eating disorders (EDs). METHODS: We used a computerized psychophysical paradigm to manipulate parametrically the quantity of signal in facial expressions of emotion (QUEST threshold seeking algorithm). This was used to measure emotion recognition in 308 adult women (anorexia nervosa [n = 61], bulimia nervosa [n = 58], healthy controls [n = 130], and mixed mental disorders [mixed, n = 59]). The M (SD) age was 22.84 (3.90) years. The aims were to establish recognition thresholds defining how much information a person needs to recognize a facial emotion expression and to identify deficits in EDs compared with healthy and clinical controls. The stimuli included six basic emotion expressions (fear, anger, disgust, happiness, sadness, surprise), plus a neutral expression. RESULTS: Happiness was discriminated at the lowest, fear at the highest threshold by all groups. There were no differences regarding thresholds between groups, except for the mixed and the bulimia nervosa group with respect to the expression of disgust (F(3,302) = 5.97, p = .001, = .056). Emotional clarity, ED pathology, and depressive symptoms did not predict performance (RChange .010, F(1,305) 5.74, p .079). The confusion matrix did not reveal specific biases in either group. CONCLUSIONS: Overall, within-subject effects were as expected, whereas between-subject effects were marginal and psychopathology did not influence emotion recognition. Facial emotion recognition abilities in women experiencing EDs compared with women experiencing mixed mental disorders and healthy controls were similar. Although basic facial emotion recognition processes seems to be intact, dysfunctional aspects such as misinterpretation might be important in emotion regulation problems. AbstractObjective: Impairments in facial emotion recognition are an underlying factor of deficits in emotion regulation and interpersonal difficulties in mental disorders, and are evident in eating disorders (EDs). Methods:We used a computerized psychophysical paradigm to manipulate parametrically the quantity of signal in facial expressions of emotion (QUEST threshold seeking algorithm). This was used to measure emotion recognition in 311 adult women (anorexia nervosa (AN,n=61), bulimia nervosa (BN,n=58), healthy controls (HC,n=130) and mixed mental disorders (mixed,n=59)). The mean age was 22.84 years (SD=3.90). The aim was to establish recognition thresholds defining how much information a person needs to recognize a facial emotion expression and to identify deficits in EDs compared to healthy and clinical controls. The stimuli included six basic emotion expressions (fear, anger, disgust, happiness, sadness, surprise) plus a neutral expression. Results:Happiness was discriminated at the lowest, fear at the highest threshold by all groups.There were no differences regarding thresholds between groups, except for th...
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