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Book: Clinical handbook of complex and atypical eating disorders

Anderson, Leslie Karwoski / Murray, Stuart B. / Kaye, Walter H.

2018

Author's details	edited by Leslie K. Anderson, Stuart B. Murray and Walter H. Kaye
Keywords	Feeding and Eating Disorders / complications ; Feeding and Eating Disorders / therapy
Language	English
Size	xx, 416 Seiten
Publisher	Oxford University Press
Publishing place	Oxford
Publishing country	Great Britain
Document type	Book
HBZ-ID	HT019473660
ISBN	978-0-19-063040-9 ; 9780190630416 ; 9780190671778 ; 0-19-063040-X ; 0190630418 ; 0190671777
Database	Catalogue ZB MED Medicine, Health

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Article ; Online: Treatment of Patients With Anorexia Nervosa in the US-A Crisis in Care.

Kaye, Walter H / Bulik, Cynthia M

JAMA psychiatry

2021 Volume 78, Issue 6, Page(s) 591–592

MeSH term(s)	Anorexia Nervosa/diagnosis ; Anorexia Nervosa/therapy ; Clinical Competence/standards ; Delivery of Health Care/standards ; Humans ; Insurance Coverage/standards ; Standard of Care/standards ; United States
Language	English
Publishing date	2021-02-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	2701203-7
ISSN	2168-6238 ; 2168-622X
ISSN (online)	2168-6238
ISSN	2168-622X
DOI	10.1001/jamapsychiatry.2020.4796
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Article: Expanding considerations for treating avoidant/restrictive food intake disorder at a higher level of care.

Richson, Brianne N / Deville, Danielle C / Wierenga, Christina E / Kaye, Walter H / Ramirez, Ana L

Journal of eating disorders

2024 Volume 12, Issue 1, Page(s) 13

Abstract: Existing descriptions of the treatment of avoidant/restrictive food intake disorder (ARFID) at higher levels of care (HLOC) for eating disorders are limited, despite HLOC settings frequently serving patients with ARFID. The purpose of this commentary is ... ...

Abstract	Existing descriptions of the treatment of avoidant/restrictive food intake disorder (ARFID) at higher levels of care (HLOC) for eating disorders are limited, despite HLOC settings frequently serving patients with ARFID. The purpose of this commentary is to expand on the preliminary literature that describes pediatric ARFID treatment at HLOC by describing two specific components of our approach to treating pediatric ARFID that may not yet have traction in the current literature. Specifically, we highlight the utility of (1) treatment accommodations that appropriately account for patients' neurodevelopmental needs (e.g., executive functioning, sensory processing) and (2) the adjunctive use of Dialectical Behavior Therapy (DBT) elements within family-based pediatric ARFID treatment. We also describe necessary future directions for research in these domains to clarify if incorporating these considerations and approaches into pediatric ARFID treatment at HLOC does indeed improve treatment outcomes.
Language	English
Publishing date	2024-01-22
Publishing country	England
Document type	Letter
ZDB-ID	2699357-0
ISSN	2050-2974
ISSN	2050-2974
DOI	10.1186/s40337-024-00972-7
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Article ; Online: Early change in gastric-specific anxiety sensitivity as a predictor of eating disorder treatment outcome.

Velkoff, Elizabeth A / Lusich, Rylee / Kaye, Walter H / Wierenga, Christina E / Brown, Tiffany A

European eating disorders review : the journal of the Eating Disorders Association

2024

Abstract: Eating disorders (EDs) are often accompanied by gastrointestinal (GI) distress. Anxiety sensitivity is the tendency to interpret sensations of anxiety as threatening or dangerous, and includes both broad physical symptoms (e.g., elevated heartrate) and ... ...

Abstract	Eating disorders (EDs) are often accompanied by gastrointestinal (GI) distress. Anxiety sensitivity is the tendency to interpret sensations of anxiety as threatening or dangerous, and includes both broad physical symptoms (e.g., elevated heartrate) and GI-specific symptoms. Physical and GI-specific anxiety sensitivity may be important risk and maintaining factors in EDs. This study tested the hypothesis that greater reductions in both types of anxiety sensitivity during the first month of treatment would predict lower ED symptoms and trait anxiety at discharge and 6-month follow-up. Patients (n = 424) in ED treatment reported physical and GI-specific anxiety sensitivity, ED symptoms, and trait anxiety at treatment admission, 1-month into treatment, discharge, and 6-month follow-up. Analyses were conducted with hierarchical linear regression with imputation, controlling for relevant covariates. Results indicated that early reduction in GI-specific but not general physical anxiety sensitivity predicted both lower ED symptoms and lower trait anxiety at discharge and 6-month follow-up. These findings demonstrate the importance of GI-specific anxiety sensitivity as a potential maintaining factor in EDs. Developing and refining treatments to target GI-specific anxiety sensitivity may have promise in improving the treatment not only of EDs, but also of commonly co-morbid anxiety disorders.
Language	English
Publishing date	2024-04-30
Publishing country	England
Document type	Journal Article
ZDB-ID	1159507-3
ISSN	1099-0968 ; 1067-1633 ; 1072-4133
ISSN (online)	1099-0968
ISSN	1067-1633 ; 1072-4133
DOI	10.1002/erv.3099
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Article ; Online: Using clinical cutoff scores on the eating disorder examination-questionnaire to evaluate eating disorder symptoms during and after naturalistic intensive treatment.

Velkoff, Elizabeth A / Brown, Tiffany A / Kaye, Walter H / Wierenga, Christina E

Eating disorders

2023 Volume 31, Issue 5, Page(s) 464–478

Abstract: Clinical cutoff scores for self-report measures provide a means of evaluating clinically significant pathology during and after treatment. A cutoff of 2.8 on the Eating Disorder Examination-Questionnaire (EDE-Q) has been recommended to screen for eating ... ...

Abstract	Clinical cutoff scores for self-report measures provide a means of evaluating clinically significant pathology during and after treatment. A cutoff of 2.8 on the Eating Disorder Examination-Questionnaire (EDE-Q) has been recommended to screen for eating disorders (ED). We used this cutoff to assess ED symptoms in adolescents (
MeSH term(s)	Adult ; Adolescent ; Humans ; Surveys and Questionnaires ; Feeding and Eating Disorders/diagnosis ; Feeding and Eating Disorders/therapy ; Self Report ; Psychometrics
Language	English
Publishing date	2023-03-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	1209799-8
ISSN	1532-530X ; 1064-0266 ; 1067-1633
ISSN (online)	1532-530X
ISSN	1064-0266 ; 1067-1633
DOI	10.1080/10640266.2023.2191488
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Article ; Online: Weight gained during treatment predicts 6-month body mass index in a large sample of patients with anorexia nervosa using ensemble machine learning.

Frank, Guido K W / Stoddard, Joel J / Brown, Tiffany / Gowin, Josh / Kaye, Walter H

The International journal of eating disorders

2024

Abstract: Objective: This study used machine learning methods to analyze data on treatment outcomes from individuals with anorexia nervosa admitted to a specialized eating disorders treatment program.: Methods: Of 368 individuals with anorexia nervosa (209 ... ...

Abstract	Objective: This study used machine learning methods to analyze data on treatment outcomes from individuals with anorexia nervosa admitted to a specialized eating disorders treatment program. Methods: Of 368 individuals with anorexia nervosa (209 adolescents and 159 adults), 160 individuals had data available for a 6-month follow-up analysis. Participants were treated in a 6-day-per-week partial-hospital program. Participants were assessed for eating disorder-specific and non-specific psychopathology. The analyses used established machine learning procedures combined in an ensemble model from support vector machine learning, random forest prediction, and the elastic net regularized regression with an exploration (training; 75%) and confirmation (test; 25%) split of the data. Results: The models predicting body mass index (BMI) at 6-month follow-up explained a 28.6% variance in the training set (n = 120). The model had good performance in predicting 6-month BMI in the test dataset (n = 40), with predicted BMI significantly correlating with actual BMI (r = .51, p = 0.01). The change in BMI from admission to discharge was the most important predictor, strongly correlating with reported BMI at 6-month follow-up (r = .55). Behavioral variables were much less predictive of BMI outcome. Results were similar for z-transformed BMI in the adolescent-only group. Length of stay was most predictive of weight gain in treatment (r = .56) but did not predict longer-term BMI. Conclusions: This study, using an agnostic ensemble machine learning approach in the largest to-date sample of individuals with anorexia nervosa, suggests that achieving weight gain goals in treatment predicts longer-term weight-related outcomes. Other potential predictors, personality, mood, or eating disorder-specific symptoms were relatively much less predictive. Public significance: The results from this study indicate that the amount of weight gained during treatment predicts BMI 6 months after discharge from a high level of care. This suggests that patients require sufficient time in a higher level of care treatment to meet their specific weight goals and be able to maintain normal weight.
Language	English
Publishing date	2024-04-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	603170-5
ISSN	1098-108X ; 0276-3478
ISSN (online)	1098-108X
ISSN	0276-3478
DOI	10.1002/eat.24208
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Article ; Online: Confirmatory factor analysis of Acute Suicidal Affective Disturbance in a sample of treatment-seeking eating disorder patients.

Velkoff, Elizabeth A / Brown, Tiffany A / Kaye, Walter H / Wierenga, Christina E

Journal of affective disorders

2023 Volume 326, Page(s) 155–162

Abstract: Introduction: We examined the factor structure of Acute Suicidal Affective Disturbance (ASAD) in individuals with eating disorders. ASAD is a proposed diagnosis with four symptoms: rapidly increasing suicidal intent, social or self-alienation, ... ...

Abstract	Introduction: We examined the factor structure of Acute Suicidal Affective Disturbance (ASAD) in individuals with eating disorders. ASAD is a proposed diagnosis with four symptoms: rapidly increasing suicidal intent, social or self-alienation, hopelessness regarding the previous symptoms, and overarousal. Methods: Patients with eating disorders (N = 378) completed self-report symptom questionnaires at admission to a partial hospitalization program for eating disorders. Using proxy measures, we conducted a confirmatory factor analysis (CFA) of the one-factor model of ASAD. Results: Initial model fit was poor. We iteratively revised the model to include theoretically-justified correlated residuals (i.e., those between items intended to measure the same ASAD symptom). After these modifications, model fit remained mediocre. We next conducted a multiple-group CFA to compare ASAD between individuals with the restricting subtype of anorexia nervosa (the "ANR" model, n = 145) and individuals with binge/purge disorders (i.e., bulimia nervosa and the binge-purge subtype of anorexia nervosa; the "BP" model, n = 234). The final model had mediocre fit with partial invariance between subgroups; the ASAD factor mean was higher in the BP model. We additionally tested a bifactor model, with similar findings. Limitations: Our use of proxy measures of ASAD items may have resulted in imprecise measurement of ASAD symptoms, pointing to the importance of future research using validated measures of ASAD. Conclusions: We found moderate support for ASAD in an eating disorder sample, with invariance between eating disorder phenotypes. Our findings suggest that the ASAD diagnosis may not fully generalize to eating disorder samples.
MeSH term(s)	Humans ; Suicidal Ideation ; Emotions ; Bulimia Nervosa/diagnosis ; Bulimia Nervosa/therapy ; Bulimia Nervosa/psychology ; Anorexia Nervosa/diagnosis ; Anorexia Nervosa/therapy ; Anorexia Nervosa/psychology ; Factor Analysis, Statistical ; Feeding and Eating Disorders/diagnosis ; Feeding and Eating Disorders/therapy
Language	English
Publishing date	2023-01-30
Publishing country	Netherlands
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	135449-8
ISSN	1573-2517 ; 0165-0327
ISSN (online)	1573-2517
ISSN	0165-0327
DOI	10.1016/j.jad.2023.01.089
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Article ; Online: Parental perceptions of participation in young adult-focused eating disorder treatment.

Peck, Stephanie Knatz / Towne, Terra / Wierenga, Christina / Perry, Taylor / Miller, McKenzie / Kim, Jessie / Kaye, Walter

European eating disorders review : the journal of the Eating Disorders Association

2024

Abstract: Background: Eating disorders (ED) are serious mental illnesses affecting young adults (YA). Parent-supported treatment for this age cohort is an important consideration given the unique developmental needs and norms of familial social support, but more ... ...

Abstract	Background: Eating disorders (ED) are serious mental illnesses affecting young adults (YA). Parent-supported treatment for this age cohort is an important consideration given the unique developmental needs and norms of familial social support, but more research is needed to understand parental perceptions of treatment involvement. Methods: 33 parent-supports of YA with ED completed self-report assessments at admission and discharge of participation in brief, intensive, young-adult focused eating disorder treatment. Assessments measured programme satisfaction, parental self-efficacy, and parent and YA report of eating disorder-related psychopathology. Repeated measures ANOVAs were used to examine pre-post outcome differences and between group differences among parent-supports and their YA (i.e., the patients) on eating disorder psychopathology, clinical impairment, and family functioning using the EDEQ/P-EDEQ Global, P-CIA/CIA, and Family Assessment Device Family Functioning scales. Group differences across time points were examined with paired sample t-tests adjusted for multiple comparisons. Changes in parental self-efficacy were examined separately using two-tailed paired sample t-tests. Results: Parents reported high acceptability and learning, improvements in self-efficacy, and significant reductions of YA psychopathology at post-treatment. Parents reported comparable reductions in ED psychopathology post-treatment, but significantly greater reductions in clinical impairment compared to YA. Measures of family functioning did not improve for either parent or YA at post-treatment. Conclusion: Results from this study suggest that parental involvement in a YA programme is feasible and acceptable from a parental perspective and improves parental self-efficacy.
Language	English
Publishing date	2024-03-21
Publishing country	England
Document type	Journal Article
ZDB-ID	1159507-3
ISSN	1099-0968 ; 1067-1633 ; 1072-4133
ISSN (online)	1099-0968
ISSN	1067-1633 ; 1072-4133
DOI	10.1002/erv.3084
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Article ; Online: Comparing changes in eating disorder psychopathology and comorbid symptoms over treatment in anorexia nervosa and atypical anorexia nervosa in a partial hospitalization program.

Perry, Taylor R / Lusich, Rylee / Billman Miller, Marley G / Kaye, Walter H / Wierenga, Christina E / Brown, Tiffany A

The International journal of eating disorders

2024

Abstract: Objective: The objective of this study is to compare treatment trajectories in anorexia nervosa (AN) and atypical AN.: Method: Adolescents and adults with AN (n = 319) or atypical AN (n = 67) in a partial hospitalization program (PHP) completed ... ...

Abstract	Objective: The objective of this study is to compare treatment trajectories in anorexia nervosa (AN) and atypical AN. Method: Adolescents and adults with AN (n = 319) or atypical AN (n = 67) in a partial hospitalization program (PHP) completed diagnostic interviews and self-report questionnaires measuring eating disorder (ED), depression, and anxiety symptoms throughout treatment. Results: Premorbid weight loss did not differ between diagnoses. Individuals with atypical AN had more comorbid diagnoses, but groups did not differ on specific diagnoses. ED psychopathology and comorbid symptoms of depression/anxiety did not differ at admission between groups nor did rate of change in ED psychopathology and comorbid symptoms of depression/anxiety from admission to 1-month. From admission to discharge, individuals with atypical AN had a faster reduction in ED psychopathology and comorbid symptoms of depression and anxiety (ps < 0.05; rs = 0.01-0.32); however, there were no group differences in ED psychopathology or depression symptoms at discharge (ps>.50; ds = .01-.30). Individuals with atypical AN had lower anxiety at discharge compared to individuals with AN (p = 0.05; d = .4). Length of stay did not differ between groups (p = 0.11; d = .21). Discussion: Groups had similar ED treatment trajectories, suggesting more similarities than differences. PHP may also be effective for AAN. Public significance: This study supports previous research that individuals with AN and atypical AN have more similarities than differences. Results from this study indicate that individuals with AN and atypical AN have similar treatment outcomes for both ED psychopathology and depressive symptoms; however, individuals with atypical AN have lower anxiety symptoms at discharge compared to individuals with AN. AN and atypical AN also have more symptom similarity at admission and throughout treatment, which challenges their current designation as distinct disorders.
Language	English
Publishing date	2024-04-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	603170-5
ISSN	1098-108X ; 0276-3478
ISSN (online)	1098-108X
ISSN	0276-3478
DOI	10.1002/eat.24221
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Article: The Link Between Alcoholism and Eating Disorders.

Lilenfeld, Lisa R / Kaye, Walter H

Alcohol health and research world

2019 Volume 20, Issue 2, Page(s) 94–99

Abstract: The comorbidity between alcoholism and eating disorders, especially in young women, is well documented. Alcohol and other drug (AOD)-use disorders are particularly common in women with bulimia nervosa. Although the mechanisms underlying the coexistence ... ...

Abstract	The comorbidity between alcoholism and eating disorders, especially in young women, is well documented. Alcohol and other drug (AOD)-use disorders are particularly common in women with bulimia nervosa. Although the mechanisms underlying the coexistence of these disorders remain unknown, recent family epidemiology studies suggest that bulimia nervosa and AOD dependence are transmitted independently in families. Furthermore, bulimia nervosa generally develops before the onset of AOD dependence. Thus, factors other than addictive behavior may contribute to the development of bulimia nervosa in a substantial proportion of women. The comorbidity of AOD-use disorders with eating disorders has implications for the treatment of the affected patients.
Language	English
Publishing date	2019-12-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	427760-0
ISSN	0090-838X
ISSN	0090-838X
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