An integrative quantitative model of factors influencing the course of anorexia nervosa over time

Yackobovitch‐Gavan, Michal; Golan, Moria; Valevski, Avi; Kreitler, Shulamit; Bachar, Eytan; Lieblich, Amia; Mitrani, Edith; Weizman, Abraham; Stein, Dan J.

doi:10.1002/eat.20624

Cited by 77 publications

(84 citation statements)

References 55 publications

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“…Steinglass and colleagues (2011) further suggest that an intervention based on exposure and response prevention, a therapeutic approach widely used in the treatment of anxiety disorders (particularly OCD), may prove efficacious in the treatment of AN. These theoretical accounts highlighting the importance of anxiety in AN are consistent with empirical findings suggesting that (a) there are high rates of co-occurrence between AN and anxiety disorders (Halmi et al, 1991; Jordon et al, 2008; Kaye et al, 2004), (b) there are greater anxiety symptoms among those with AN compared to healthy controls (Frank et al, 2012), even after weight restoration (Wagner et al, 2007), and (c) anxiety symptoms may differentiate patients who do and do not experience remission from AN (Yackobovitch-Gavan et al, 2009). In sum, both conceptual accounts and empirical findings support the importance of anxiety in the etiology/maintenance and treatment AN.…”

Section: Daily Patterns Of Anxiety In Anorexia Nervosa: Associations supporting

confidence: 83%

Daily patterns of anxiety in anorexia nervosa: Associations with eating disorder behaviors in the natural environment.

Lavender¹,

Young²,

Wonderlich³

et al. 2013

Journal of Abnormal Psychology

104

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The role of anxiety has been emphasized in etiological/maintenance models of anorexia nervosa. This study identified daily patterns of anxiety in anorexia nervosa and examined the likelihood of the occurrence of eating disorder behaviors in each trajectory, the daily temporal distribution of eating disorder behaviors in each trajectory, and the extent to which the tendency to exhibit particular anxiety trajectories was associated with baseline diagnostic and trait-level personality variables. Women with full or subthreshold anorexia nervosa (N = 118) completed a two-week ecological momentary assessment (EMA) protocol during which they reported on a variety of behavioral and affective variables, including anxiety and eating disorder behaviors. Using latent growth mixture modeling to classify EMA days (N = 1526) based on anxiety ratings, seven distinct daily anxiety trajectories were identified. Overall differences between trajectories were found for rates of binge eating, self-induced vomiting, body checking, skipping meals, and dietary restriction. Further, distinct daily temporal distributions of eating disorder behaviors were found across the trajectories, with peaks in the probability of behaviors frequently coinciding with high levels of anxiety. Finally, traits of personality pathology (affective lability, self-harm, social avoidance, and oppositionality) and the presence of a co-occurring mood disorder were both found to be associated with the tendency to experience particular daily anxiety trajectories (e.g., Stable High anxiety). Findings support the presence of within-person variability in daily anxiety patterns in anorexia nervosa and also provide evidence for an association between these anxiety patterns and eating disorder behaviors.

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Section: Daily Patterns Of Anxiety In Anorexia Nervosa: Associations supporting

confidence: 83%

Daily patterns of anxiety in anorexia nervosa: Associations with eating disorder behaviors in the natural environment.

Lavender¹,

Young²,

Wonderlich³

et al. 2013

Journal of Abnormal Psychology

104

View full text Add to dashboard Cite

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“…It increased significantly during hospitalization, reaching almost normal ranges at discharge (Bray 1992). The six patients assessed with the EDFHI at follow-up were all considered remitted (Strober et al 1997;Yackobovitch-Gavan et al 2009), as their BMI was within normal range (Bray 1992), they had regular menstrual periods, and none had evidence of restricting, bingeing and/or purging behaviours for at least 12 consecutive months.…”

Section: Resultsmentioning

confidence: 99%

“…Higher scores indicate more anxiety symptoms. The STAI has been previously used in eating disorders patients (Pollice et al 1997), including in Israeli Samples (Yackobovitch-Gavan et al 2009). …”

Section: Participantsmentioning

confidence: 99%

Irreversibility of cardiac autonomic dysfunction in female adolescents diagnosed with anorexia nervosa after short- and long-term weight gain

Lachish

Stein

Kaplan

et al. 2009

The World Journal of Biological Psychiatry

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Anorexia nervosa (AN) patients may present with cardiac autonomic system dysfunction. Power spectral analysis of heart rate variability (HRV) is a reliable noninvasive examination for the quantitative assessment of the central sympathovagal interaction that modulates cardiovascular autonomic function. In the present study, HRV parameters were assessed in female adolescent AN inpatients in the malnourished phase at admission, at discharge when achieving weight restoration, and 24-36 months after discharge, when considered remitted. Nineteen normal-weight female controls were similarly assessed. Spectral analysis of HRV was done with the fast Fourier transform algorithm. At admission and discharge, patients underwent routine laboratory examinations and responded to questionnaires assessing eating-related preoccupations, behaviors, and personality attributes, depression and anxiety. Compared with the controls, AN patients had significantly lower heart-rate and HRV, lower total power and low frequency components, elevated high frequency components, and decreased low to high frequency power ratio as assessed with the power spectral analysis at all three evaluation points. These disturbances were not correlated with the baseline laboratory and psychometric measures. Our preliminary findings suggest that female adolescent AN inpatients may have a cardiovascular autonomic dysfunction in the form of vagal abnormality present not only in malnourished patients, but also persisting following short-term and long-term weight restoration.

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“…The diagnosis of AN was established according to the criteria of the DSM-IV-TR [2] using the Eating Disorders Family History Interview (EDFHI) [24,25]. All 19 patients would have also been diagnosed with AN according to the criteria of the DSM-V [26].…”

Section: Patientsmentioning

confidence: 99%

Alteration in serum klotho levels in anorexia nervosa patients

et al. 2016

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An integrative quantitative model of factors influencing the course of anorexia nervosa over time

Abstract: Elevated anxiety and eating-related obsessionality may increase the risk for the development of AN and for nonremission.

Cited by 77 publications

References 55 publications

Daily patterns of anxiety in anorexia nervosa: Associations with eating disorder behaviors in the natural environment.

Daily patterns of anxiety in anorexia nervosa: Associations with eating disorder behaviors in the natural environment.

Irreversibility of cardiac autonomic dysfunction in female adolescents diagnosed with anorexia nervosa after short- and long-term weight gain

Alteration in serum klotho levels in anorexia nervosa patients

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