Core psychopathology of treatment-seeking patients with binge-eating disorder: a network analysis investigation

Abstract

BackgroundMental disorders may emerge as the result of interactions between observable symptoms. Such interactions can be analyzed using network analysis. Several recent studies have used network analysis to examine eating disorders, indicating a core role of overvaluation of weight and shape. However, no studies to date have applied network models to binge-eating disorder (BED), the most prevalent eating disorder.MethodsWe constructed a cross-sectional graphical LASSO network in a sample of 788 individuals with BED. Symptoms were assessed using the Eating Disorders Examination Interview. We identified core symptoms of BED using expected influence centrality.ResultsOvervaluation of shape emerged as the symptom with the highest centrality. Dissatisfaction with weight and overvaluation of weight also emerged as highly central symptoms. On the other hand, behavioral symptoms such as binge eating, eating in secret, and dietary restraint/restriction were less central. The network was stable, allowing for reliable interpretations (centrality stability coefficient = 0.74).ConclusionsOvervaluation of shape and weight emerged as core symptoms of BED. This trend is consistent with past network analyses of eating disorders more broadly, as well as literature that suggests a primary role of shape and weight concerns in BED. Although DSM-5 diagnostic criteria for BED does not currently include a cognitive criterion related to body image or shape/weight overvaluation, our results provide support for including shape/weight overvaluation as a diagnostic specifier.

Obsessive–compulsive symptoms in eating disorders: A network investigation

“…Overall, this ED network shows that cognitive symptoms are highly interconnected as are behavioral symptoms. This is consistent with previous network analyses investigating symptomatic interplay in AN and BN (Forrest et al, ) and BED (Wang et al, ). Considering that the dominant rationale in cognitive behavioral therapy is to modify cognitions in the service of promoting positive behavioral change, this is especially striking.…”

“…Over the last few years, a growing number of network studies has investigated the symptomatic interplay within ED clusters, for example, for AN (e.g., Forrest, Jones, Ortiz, & Smith, 2018), BN (e.g., Levinson, Rapp, & Riley, 2014), and binge eating disorder (BED; Wang, Jones, Dreier, Elliott, & Grilo, 2019). Consistent with Fairburn's (2008) transdiagnostic model of EDs, they have confirmed the importance ("centrality") of overevaluation of shape and weight (DuBois, Rodgers, Franko, Eddy, & Thomas, 2017;Forrest et al, 2018;Wang et al, 2019) across ED subtypes. Moreover, fear of weight gain emerged as a highly important symptom in both BN (Levinson et al, 2014) and AN networks (Forrest et al, 2018).…”

Application of network analysis to investigate sex differences in interactive systems of eating‐disorder psychopathology

“…Consistent with this body of research, we hypothesized that the most central symptoms for men and women would be similar. Additionally, we hypothesized that consistent with the Transdiagnostic Model of EDs and past research on network analysis and EDs (DuBois et al, 2017;Forbush et al, 2016;Forrest et al, 2018;Goldschmidt et al, 2018;Wang et al, 2018), items related to overvaluation of weight, shape, and the strict control of weight and shape would emerge as most central to the networks for both sexes.…”

“…Existing research on network analyses in EDs supports the Transdiagnostic Model (DuBois, Rodgers, Franko, Eddy, & Thomas, ). In multiple studies of individuals with EDs, items related to overvaluation of weight, shape, and the strict control of weight and shape emerged among the most central nodes of the network (DuBois et al, ; Forbush, Siew, & Vitevitch, ; Forrest, Jones, Ortiz, & Smith, Goldschmidt et al, ; Wang, Jones, Dreier, Elliott, & Grilo, ). Past research also suggests that dietary restraint plays an important role in the maintenance of eating pathology (DuBois et al, ; Forrest et al, ).…”

“…Future studies are needed to test this supposition-that is, if one controls for severity, does targeting dietary restraint and other key symptoms produce similar changes in overall ED psychopathology in men versus women?Our assessment measures may have also contributed to the discrepancy between our results and other research that has identified items related to overvaluation of weight and shape to be most central to networks of ED symptoms. The majority of prior network studies in the field of EDs used the EDE or EDE-Q(Elliott et al, in press;Forrest et al, 2018;Goldschmidt et al, 2018;Levinson et al, 2017;Wang et al, 2018), rather than the EPSI(DuBois et al, 2017;Forbush et al, 2016). Past studies that used the EPSI produced results that highlight the importance of restricting behaviors and cognitive restraint(DuBois et al, 2017;Forbush et al, 2016).…”