Elevated Neurobehavioral Responses to Negative Social Interactions in Women With Bulimia Nervosa

Luo, Yi; Mendoza, Carlisdania; Pelfrey, Sarah; Lohrenz, Terry; Gu, Xiaosi; Montague, P. Read; McAdams, Carrie J.

doi:10.1016/j.bpsc.2021.01.011

Cited by 5 publications

(4 citation statements)

References 53 publications

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“…This finding highlights the importance of investigating underlying specific ED fears and considering the social context around those fears. It also supports previous research which suggests altered processing during social interactions is a key feature of BN pathology and that individuals with AN have severe deficits in social cognitions (Luo et al, 2021; McAdams & Krawczyk, 2011). In addition, literature suggests that socioemotional and interpersonal components play a key role in the development and maintenance of EDs, especially AN (Treasure & Schmidt, 2013).…”

Section: Discussionsupporting

confidence: 89%

Core eating disorder fears: Prevalence and differences in eating disorder fears across eating disorder diagnoses

Brown

Levinson

2022

Intl J Eating Disorders

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Objective: Fear and anxiety are key maintaining factors for eating disorder (ED) pathology. Maladaptive fears lead to ED behaviors and avoidance, which provide temporary relief, but ultimately reinforce the fear and contribute to a cycle that maintains the ED. To date, fears of food and weight gain are the most explored fears underlying ED pathology. However, recently other important ED fears have been identified, including fears of social consequences and personal consequences.Method: The current study (N = 229 individuals with an ED) aimed to better characterize ED fears. Specifically, this study examined which ED fears were most endorsed across and within ED diagnoses, and if there were differences in ED fears by diagnosis and by weight status.Results: Overall, fear of gaining weight was the most frequently endorsed fear, followed by fear of food, and fear of judgment. Individuals with anorexia nervosa (AN) most frequently endorsed fear of food, individuals with atypical AN and bulimia nervosa: fear of gaining weight, and those with other specified feeding and eating disorder: fear of judgment. Limited differences were found between diagnoses.When examining by weight category, participants with underweight most frequently endorsed fear of food, participants with normal weight: fear of gaining weight, and participants with overweight and obesity: fear of judgment. Discussion: These findings suggest ED fears are heterogenous. Given such high heterogeneity, this work highlights the importance of assessing for specific ED fears at the beginning of treatment, which could be used to deliver personalized exposure treatment. Public Significance Statement: Eating disorders (EDs) are serious mental illnesses with high rates of medical and psychiatric comorbidities. Fear plays an important role in the development and maintenance of EDs. The present study found fear of food, weight gain, and judgment are the most frequently endorsed fears for individuals with EDs and found few differences in fears based on ED diagnosis. These findings highlight the importance of assessing individuals' specific ED fears for treatment.

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Section: Discussionsupporting

confidence: 89%

Core eating disorder fears: Prevalence and differences in eating disorder fears across eating disorder diagnoses

Brown

Levinson

2022

Intl J Eating Disorders

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“…Both individuals with anorexia nervosa (AN) and those with bulimia nervosa (BN) also demonstrate deficits in theory of mind [ 17 ]. Neural differences during social perspective-taking and social interactions are found in both AN and BN, providing further neural evidence suggesting the presence of social perceptual differences [ 18 – 21 ]. Interventions that alter social perceptions and behaviors may help patients to obtain social support, a factor that could improve both quality of life and psychiatric symptoms for individuals with EDs.…”

Section: Introductionmentioning

confidence: 88%

Qualitative patient experiences from the Self-Blame and Perspective-Taking Intervention for eating disorders

et al. 2021

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Background Problems in social cognition and social support contribute to eating disorders (ED). Group therapy provides an ideal format to create an experiential learning environment focused on understanding social interactions. This pilot study examined the qualitative content of the participants’ experiences in the Self-Blame and Perspective-Taking Intervention (SBPI) for ED. Methods The SBPI was a 4-week group therapy intervention involving art therapy and psychoeducation that focused on social behaviors in ED patients. Participants received surveys immediately after the intervention and at 1 to 4 weeks after the post-intervention. Thematic analyses of qualitative feedback were performed using Braun and Clarke’s thematic analysis framework. Results Inductive analyses revealed three main themes: (1) Developing self-acceptance through emotional reflection, (2) Changing expectations with neurosocial knowledge, and (3) Bonding and vulnerability in social interactions; all concepts intentionally targeted by the SBPI. Participants varied in their support of a guideline to exclude personal discussion of ED-related cognitions and behaviors in the group. Conclusions As a whole, patients valued the combination of psychosocial education with group experientials focused on social behavior. Positive feedback from the SBPI suggests that adjunctive treatments that target mental-wellness constructs indirectly related to ED pathology may be helpful by allowing patients to see themselves as separable from the illness. Trial registration ClinicalTrials.gov, NCT0487758. Registered 7 May 2021—Retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT04877158.

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“…In this respect, women with BN undergoing experimental exposure to social interactions with negative reciprocity are reported to express more negative behavioral responses and stronger neural activations in the cortical and subcortical brain regions than healthy women. On the other hand, exposure to positive reciprocity interactions was not associated with any behavioral or neural differences, denoting amplification of negative self-relevant social interactions in BN [ 17 ]. Similar alterations (e.g., subcortical activations involving the amygdala and dorsal striatum) are noticed in the acute phase in those patients [ 17 ], denoting that negative social interactions represent manifest triggers of ED pathologies.…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, exposure to positive reciprocity interactions was not associated with any behavioral or neural differences, denoting amplification of negative self-relevant social interactions in BN [ 17 ]. Similar alterations (e.g., subcortical activations involving the amygdala and dorsal striatum) are noticed in the acute phase in those patients [ 17 ], denoting that negative social interactions represent manifest triggers of ED pathologies.…”

Section: Introductionmentioning

confidence: 99%

The Bergen Facebook Addiction Scale: its psychometric properties and invariance among women with eating disorders

et al. 2022

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Objective Facebook addiction is increasing, giving rise to limited real-life social networks, loneliness, poor work and academic performance, psychopathology, and low well-being. Facebook entails numerous factors that increase the risk for disordered eating attitudes and behaviors (e.g., use time and Facebook activities such as social grooming and photo sharing). This study aimed to evaluate the psychometric properties of the Bergen Facebook Addiction Scale (BFAS) among patients with eating disorders (EDs) given lack of validation of Facebook addiction measures in this population. Methods A cross-sectional study involving 123 inpatient and outpatient women with EDs (Mean age = 27.3, SD = 10.6, range = 14–59 years) used confirmatory factor analysis (CFA), multigroup CFA, structural equation modeling (SEM), Spearman’s rho Spearman’s analysis, McDonald's Omega (ω), Cronbach’s alpha (α), and item-total correlations to examine the structure, invariance, criterion validity, reliability, and discriminant validity of the BFAS. Results Correlating the residuals of items 2, 3, and 5 resulted in an excellent fit of a one-factor structure of the BFAS (χ2(7) = 8.515, p = .289, CFI = .998, TLI = .996, RMSEA = .042, SRMR = .0099). The BFAS was invariant at the configural, metric, and scalar levels across groups of EDs, age, education, and marital status. High values of ω and α (.96) as well as item-total correlations (.851–.929) indicated excellent reliability and high discrimination index of the BFAS. Criterion validity is noted by strong positive correlation with the Six-item Internet Addiction Test (S-IAT, r = .88) and SEM using the S-IAT to predict the BFAS (χ2(49) = 103.701, p = .001, CFI = .975, TLI = .966, RMSEA = .096, SRMR = .0317).. Conclusion The BFAS is a reliable unidimensional measure. Its high discrimination index and invariance across different groups make it useful for detecting Facebook addiction among patients with ED.

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Elevated Neurobehavioral Responses to Negative Social Interactions in Women With Bulimia Nervosa

Cited by 5 publications

References 53 publications

Core eating disorder fears: Prevalence and differences in eating disorder fears across eating disorder diagnoses

Core eating disorder fears: Prevalence and differences in eating disorder fears across eating disorder diagnoses

Qualitative patient experiences from the Self-Blame and Perspective-Taking Intervention for eating disorders

The Bergen Facebook Addiction Scale: its psychometric properties and invariance among women with eating disorders

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