Understanding outcomes in family-based treatment for adolescent anorexia nervosa: a network approach

Hagan, Kelsey E.; Matheson, Brittany E.; Datta, Nandini; L’Insalata, Alexa; Onipede, Z. Ayotola; Gorrell, Sasha; Mondal, Sangeeta; Bohon, Cara; Grange, Daniel Le; Lock, James

doi:10.1017/s0033291721001604

Cited by 25 publications

(44 citation statements)

References 55 publications

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“…Firstly, Levinson and coworkers in three different papers [ 57 – 59 ] used panel data to estimate interindividual networks (temporal, contemporaneous, and between-subject), as well as intra-individual networks (temporal and contemporaneous) for some of the patients in the sample. Other relevant studies aimed at assessing the treatment efficacy by applying statistical techniques [ 34 , 36 , 38 , 44 , 51 , 52 , 66 , 79 ].…”

Section: Resultsmentioning

confidence: 99%

Network-based methods for psychometric data of eating disorders: A systematic review

Punzi

Petti²,

Tieri³

2022

PLoS ONE

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Background Network science represents a powerful and increasingly promising method for studying complex real-world problems. In the last decade, it has been applied to psychometric data in the attempt to explain psychopathologies as complex systems of causally interconnected symptoms. One category of mental disorders, relevant for their severity, incidence and multifaceted structure, is that of eating disorders (EDs), serious disturbances that negatively affect a person’s eating behavior. Aims We aimed to review the corpus of psychometric network analysis methods by scrutinizing a large sample of network-based studies that exploit psychometric data related to EDs. A particular focus is given to the description of the methodologies for network estimation, network description and network stability analysis providing also a review of the statistical software packages currently used to carry out each phase of the network estimation and analysis workflow. Moreover, we try to highlight aspects with potential clinical impact such as core symptoms, influences of external factors, comorbidities, and related changes in network structure and connectivity across both time and subpopulations. Methods A systematic search was conducted (February 2022) on three different literature databases to identify 57 relevant research articles. The exclusion criteria comprehended studies not based on psychometric data, studies not using network analysis, studies with different aims or not focused on ED, and review articles. Results Almost all the selected 57 papers employed the same analytical procedures implemented in a collection of R packages specifically designed for psychometric network analysis and are mostly based on cross-sectional data retrieved from structured psychometric questionnaires, with just few exemptions of panel data. Most of them used the same techniques for all phases of their analysis. In particular, a pervasive use of the Gaussian Graphical Model with LASSO regularization was registered for in network estimation step. Among the clinically relevant results, we can include the fact that all papers found strong symptom interconnections between specific and nonspecific ED symptoms, suggesting that both types should therefore be addressed by clinical treatment. Conclusions We here presented the largest and most comprehensive review to date about psychometric network analysis methods. Although these methods still need solid validation in the clinical setting, they have already been able to show many strengths and important results, as well as great potentials and perspectives, which have been analyzed here to provide suggestions on their use and their possible improvement.

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Section: Resultsmentioning

confidence: 99%

Network-based methods for psychometric data of eating disorders: A systematic review

Punzi

Petti²,

Tieri³

2022

PLoS ONE

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“…Finally, they observed that centrality of symptoms at baseline was significantly associated with prognostic values for both recovery status and clinical impairment. Similarly, Hagan et al (2021) found that pretreatment central symptoms in adolescents with AN significantly predicted early response but did not predict remission. A third study (Olatunji et al, 2018) also found that the most central symptoms, namely interoceptive awareness and ineffectiveness , did not change after treatment.…”

Section: Resultsmentioning

confidence: 95%

“…assessment of treatment outcome (Calugi et al, 2021; Elliott et al, 2020; Hagan et al, 2021; Hilbert et al, 2020; Olatunji et al, 2018; Smith et al, 2019).…”

Section: Resultsmentioning

confidence: 99%

“…Firstly, Levinson and coworkers in three different papers (2021; 2018; 2020) used panel data to estimate interindividual networks (temporal, contemporaneous, and between-subject), as well as intra-individual networks (temporal and contemporaneous) for some of the patients in the sample. Other relevant studies aimed at assessing the treatment efficacy by applying statistical techniques (Brown et al, 2020; Calugi et al, 2021; Christian et al, 2020; Elliott et al, 2020; Hagan et al, 2021; Hilbert et al, 2020; Smith et al, 2019).…”

Section: Resultsmentioning

confidence: 99%

“…Centr. Measure References Shape and weight preoccupation and overvaluation, body dissatisfaction S and EI Calugi et al, 2020;DuBois et al, 2017;Elliott et al, 2020;Forbush et al, 2016;Forrest et al, 2018;Forrest, Perkins, et al, 2019;Forrest, Sarfan, et al, 2019;Goldschmidt et al, 2018;Kenny et al, 2021;Kinkel-Ram et al, 2021;Levinson et al, 2021;Mares et al, 2021;Meier et al, 2020;Rodgers et al, 2019;Vanzhula et al, 2019;Wang et al, 2019 Fear of weight gain S and EI Calugi et al, 2021;Calugi et al, 2020;Elliott et al, 2020;Forrest et al, 2018;Goldschmidt et al, 2018;Hagan et al, 2021;Kinkel-Ram et al, 2021;Levinson et al, 2021;Levinson et al, 2020;Levinson et al, 2017;Meier et al, 2020;Perez et al, 2021;Rodgers et al, 2019;Vanzhula et al, 2019 Drive for thinness S, EI, C and B Brown et al, 2020;Cascino et al, 2019;Christian et al, 2021;De Paoli et al, 2020;Elliott et al, 2020;Forrest, Perkins, et al, 2019;Hagan et al, 2021;Kinkel-Ram et al, 2021;…”

Section: Symptommentioning

confidence: 99%

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Network-Based Methods for Psychometric Data of Eating Disorders: A Systematic Review

Punzi

Petti

Tieri

2022

Preprint

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Network science represents a powerful and increasingly promising method for studying complex real-world problems. In the last decade, it has been applied to psychometric data in the attempt to explain psychopathologies as complex systems of causally interconnected symptoms. With this work, we aimed to review a large sample of network-based studies that exploit psychometric data related to eating disorders (EDs) trying to highlight important aspects such as core symptoms, influences of external factors, comorbidities, and changes in network structure and connectivity across both time and subpopulations. A particular focus is here given to the potentialities and limitations of the available methodologies used in the field. At the same time, we also give a review of the statistical software packages currently used to carry out each phase of the network estimation and analysis workflow. Although many theoretical results, especially those concerning the ED core symptoms, have already been confirmed by multiple studies, their supporting function in clinical treatment still needs to be thoroughly assessed.

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Lessons learned developing and testing family‐based interoceptive exposure for adolescents with low‐weight eating disorders

Hildebrandt

Peyser

Sysko

2021

Intl J Eating Disorders

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Background Anorexia nervosa (AN) usually develops in early adolescence and is characterized by high rates of morbidity and mortality. Family‐based therapy (FBT) is the leading evidence‐based treatment for adolescents with AN, but not all patients experience sufficient improvement. The purpose of this manuscript is to describe the development and subsequent experience with a Family‐Based Interoceptive Exposure (FBT‐IE) for adolescents with a broader form of low‐weight eating disorders. Methods The novel IE‐based behavioral intervention is a six‐session family‐based treatment module designed to directly target and modify disgust by altering the prefrontal regulation of the insula response to aversive stimuli by decreasing visceral sensitivity (e.g., bloating). Each session teaches a new skill regarding tolerating distress to visceral sensations associated with disgust and an in‐vivo “IE exercise,” in which the family is provided with a meal replacement shake of unknown content and caloric density. Results In this novel treatment, the patient learns to tolerate disgust in the context of a challenging food stimulus as a way to increase consumption of restricted foods outside of session. Conclusion We discuss successes and challenges executing this treatment with patients with low‐weight eating disorders and propose future directions for the intervention.

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Understanding outcomes in family-based treatment for adolescent anorexia nervosa: a network approach

Cited by 25 publications

References 55 publications

Network-based methods for psychometric data of eating disorders: A systematic review

Network-based methods for psychometric data of eating disorders: A systematic review

Network-Based Methods for Psychometric Data of Eating Disorders: A Systematic Review

Lessons learned developing and testing family‐based interoceptive exposure for adolescents with low‐weight eating disorders

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