| 1. |
- Carlsson, Martin, et al.
(author)
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Directly measured free 25-hydroxy vitamin D levels show no evidence of vitamin D deficiency in young Swedish women with anorexia nervosa
- 2018
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In: Eating and Weight Disorders. - : Springer. - 1124-4909 .- 1590-1262. ; 23:2, s. 247-254
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Journal article (peer-reviewed)abstract
- Purpose Anorexia nervosa (AN) is an eating disorder characterized by low fat mass complicated by osteoporosis. The role of circulating vitamin D in the development of bone loss in AN is unclear. Fat mass is known to be inversely associated with vitamin D levels measured as serum levels of total, protein-bound 25-hydroxyvitamin D, but the importance of directly measured, free levels of 25(OH)D has not been determined in AN. The aim of this study was to investigate vitamin D status, as assessed by serum concentrations of total and free serum 25(OH)D in patients with AN and healthy controls. Methods In female AN patients (n = 20), and healthy female controls (n = 78), total 25(OH)D was measured by LC-MS/MS, and free 25(OH)D with ELISA. In patients with AN bone mineral density (BMD) was determined with DEXA. Results There were no differences between patients and controls in total or free S-25(OH)D levels (80 +/- 31 vs 72 +/- 18 nmol/L, and 6.5 +/- 2.5 vs 5.6 +/- 1.8 pg/ml, respectively), and no association to BMD was found. In the entire group of patients and controls, both vitamin D parameters correlated with BMI, leptin, and PTH. Conclusions The current study did not demonstrate a vitamin D deficiency in patients with AN and our data does not support vitamin D deficiency as a contributing factor to bone loss in AN. Instead, we observed a trend toward higher vitamin D levels in AN subjects compared to controls. Measurement of free vitamin D levels did not contribute to additional information.
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| 2. |
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| 5. |
- Duarte, Cristiana, et al.
(author)
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Normative body dissatisfaction and eating psychopathology in teenage girls : the impact of inflexible eating rules
- 2016
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In: Eating and Weight Disorders. - : Springer. - 1124-4909 .- 1590-1262. ; 21:1, s. 41-48
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Journal article (peer-reviewed)abstract
- Adolescence has been considered a critical time for the development of body image-related difficulties and disordered eating behaviours, especially in females. Although adherence to eating rules has been linked to disordered eating, literature has not yet explored how the inflexible subscription to those rules impacts on eating psychopathology. Therefore, the aim of the current study was to explore whether inflexible eating impacts on the relationships between weight and body image-related variables, and disordered eating.Participated in this study are 497 female adolescents from the community, aged between 14 and 18 years old, who completed self-report measures.Results revealed that the majority of the participants were dissatisfied with their weight and body shape. Moreover, 6.64 % of the participants demonstrated severe eating psychopathology. A path analysis revealed that BMI, body dissatisfaction and social comparisons based on physical appearance impact on disordered eating behaviours, through the mechanism of inflexible adherence to eating rules. This model explained 52 % of eating psychopathology's variance.Findings highlight the relevance of body image-related difficulties in adolescence and additionally they emphasise the importance of promoting more flexible attitudes towards eating in prevention and intervention programmes with female adolescents.
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| 6. |
- Ferreira, Cláudia, et al.
(author)
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Body image-related cognitive fusion as a main mediational process between body-related experiences and women’s quality of life
- 2015
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In: Eating and Weight Disorders. - : Springer. - 1124-4909 .- 1590-1262. ; 20:1, s. 91-97
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Journal article (peer-reviewed)abstract
- Purpose: Although the experience of body image has been considered an important indicator of women's psychological quality of life (QoL), it has also been suggested that the impact of unwanted body-related experiences on QoL may be mediated by emotional regulation processes. The aim of the current study was therefore to explore for the first time the role of body image-related cognitive fusion on these associations.Methods: This study comprised 779 young females who completed self-report measures. A path analysis was conducted to explore whether BMI, body dissatisfaction and feelings of inferiority based on physical appearance would impact on psychological QoL through body image-related cognitive fusion.Results: The model explained 39 % of psychological health, and revealed an excellent fit. Results showed that BMI did not directly impact on psychological health. Furthermore, the effects of increased body dissatisfaction and feelings of inferiority based on physical appearance on psychological health were fully and partially mediated by body image-related cognitive fusion, respectively.Conclusions: These findings suggest that the presence of body image-related negative experiences does not necessarily lead to impairment in women's QoL, which is rather dependent upon one's ability to observe these unwanted experiences as transient and subjective. Therefore, intervention programmes aiming at increasing women's QoL should focus on targeting emotional regulation processes in order to develop the ability to pursue life goals and values, even in the presence of unwanted experiences concerning body image.
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| 7. |
- Ferreira, Cláudia, et al.
(author)
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Explaining rigid dieting in normal-weight women : the key role of body image inflexibility
- 2016
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In: Eating and Weight Disorders. - : Springer. - 1124-4909 .- 1590-1262. ; 21:1, s. 49-56
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Journal article (peer-reviewed)abstract
- Restrictive dieting is an increasing behavior presented by women in modern societies, independently of their weight. There are several known factors that motivate diet, namely a sense of dissatisfaction with one's body and unfavorable social comparisons based on physical appearance. However, dieting seems to have a paradoxical effect and has been considered a risk factor for weight gain and obesity in women and for maladaptive eating. Nevertheless, the study of the emotional regulation processes that explain the adoption of inflexible and rigid eating behaviors still remains little explored. In this line, the present study aims to explore why normal-weight women engage in highly rigid and inflexible diets. We hypothesize that body and weight dissatisfaction and unfavorable social comparisons based on physical appearance explain the adoption of inflexible eating rules, through the mechanisms of body image inflexibility. The current study comprised 508 normal-weight female college students. Path analyses were conducted to explore the study's hypotheses. Results revealed that the model explained 43 % of inflexible eating and revealed excellent fit indices. Furthermore, the unwillingness to experience unwanted events related to body image (body image inflexibility) mediated the impact of body dissatisfaction and unfavorable social comparisons on the adoption of inflexible eating rules. This study highlights the relevance of body image inflexibility to explain rigid eating attitudes, and it seems to be an important avenue for the development of interventions focusing on the promotion of adaptive attitudes towards body image and eating in young women.
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| 8. |
- Ferreira, Cláudia, et al.
(author)
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How do warmth, safeness and connectedness-related memories and experiences explain disordered eating?
- 2018
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In: Eating and Weight Disorders. - : Springer. - 1124-4909 .- 1590-1262. ; 23:5, s. 629-636
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Journal article (peer-reviewed)abstract
- Literature suggested that the recall of early positive experiences have a major impact on the promotion of feelings of connectedness and social safeness, and seems to protect individuals against psychopathology. Recent research has also demonstrated that the absence of these positive rearing memories play a key role on disordered eating-related behaviours. The impact of early affiliative memories on disordered eating do not seem to be direct, and the mechanisms underlying this relationship are scarcely investigated. The present study aimed to clarify how memories of warmth and safeness explain the adoption of disordered eating attitudes, and tested the mediator role of social safeness, external shame and appearance-focused social comparison on aforementioned relationship, in a sample of 277 young women. The tested model explained 36% of eating psychopathology's variance and presented an excellent fit. Path analysis results indicated that the impact of rearing memories on eating psychopathology was fully mediated through the mechanisms of social safeness, external shame and appearance-focused social comparison. Specifically, these findings suggested that the extent to which positive rearing memories are associated with lower levels of disordered eating attitudes is influenced by the current feelings of social safeness and connectedness, which in turn are totally carried by decreased feelings of external shame and by lower endorsement on unfavourable comparison based on physical appearance with proximal targets (peers). These results seem to offer important insights for research and clinical work on body image and eating-related difficulties, suggesting the relevance of promoting warm and safe interactions with others.Level of evidenceLevel V, descriptive study.
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| 9. |
- Ferreira, Cláudia, et al.
(author)
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When thought suppression backfires : its moderator effect on eating psychopathology
- 2015
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In: Eating and Weight Disorders. - : Springer. - 1124-4909 .- 1590-1262. ; 20:3, s. 355-362
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Journal article (peer-reviewed)abstract
- Recently, several studies have pointed the importance of thought suppression as a form of experiential avoidance in different psychopathological conditions. Thought suppression may be conceptualized as an attempt to decrease or eliminate unwanted internal experiences. However, it encloses a paradoxical nature, making those thoughts hyper accessible and placing an extra burden on individuals. This avoidance process has been associated with several psychopathological conditions. However, its role in eating psychopathology remains unclear. The present study aims to explore the moderation effect of thought suppression on the associations between body image-related unwanted internal experiences (unfavorable social comparison through physical appearance and body image dissatisfaction) and eating psychopathology severity in a sample of 211 female students. Correlational analyses showed that thought suppression is associated with psychological inflexibility and eating disorders' main risk factors and symptoms. Moreover, two independent analyses revealed that thought suppression moderates, as it amplifies, the impact of unfavorable social comparisons through physical appearance (model 1) and body image dissatisfaction (model 2) on disordered eating attitudes and behaviors. Hence, for the same level of these body-related internal experiences, young females who reveal higher levels of thought suppression present higher eating psychopathology. Taken together, these findings highlight the key role of thought suppression in eating psychopathology and present important clinical implications.
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| 12. |
- Gezelius, Christina, et al.
(author)
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Adolescent patients with eating disorders and their parents : a study of self-image and outcome at an intensive outpatient program
- 2016
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In: Eating and Weight Disorders. - : Springer Science and Business Media LLC. - 1124-4909 .- 1590-1262. ; 21:4, s. 607-616
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Journal article (peer-reviewed)abstract
- Purpose The main aim of this clinical study was to explore how adolescent patients with eating disorders and their parents report their perceived self-image, using Structural Analysis of Social Behavior (SASB), before and after treatment at an intensive outpatient program. Another aim was to relate the self-image of the young patients to the outcome measures body mass index (BMI) and Children's Global Assessment Scale (C-GAS) score.Methods A total of 93 individuals (32 adolescents, 34 mothers, and 27 fathers) completed the SASB self-report questionnaire before and after family-based treatment combined with an individual approach at a child and youth psychiatry day care unit. The patients were also assessed using the C-GAS, and their BMI was calculated.Results The self-image (SASB) of the adolescent patients was negative before treatment and changed to positive after treatment, especially regarding the clusters self-love (higher) and self-blame (lower). A positive correlation between change in self-love and in C-GAS score was found, which rose significantly. Increased self-love was an important factor, explaining a variance of 26 %. BMI also increased significantly, but without any correlation to change in SASB. The patients' fathers exhibited low on the cluster self-protection. Mothers' profiles were in line with a non-clinical group.Conclusions Results indicate that the self-image of adolescent patients change from negative to positive alongside with a mainly positive outcome of the ED after treatment. Low self-protection according to SASB among fathers suggests the need for greater focus on their involvement.
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| 13. |
- Mendes, Ana Laura, et al.
(author)
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The central role of self-reassurance to explain body and eating attitudes
- 2019
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In: Eating and Weight Disorders. - : Springer. - 1124-4909 .- 1590-1262. ; 24:5, s. 861-868
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Journal article (peer-reviewed)abstract
- Literature has emphasized the significant role of social acceptance and connectedness in well-being and the benefits of cultivating a positive body image in the prevention and treatment of body and eating-related difficulties. The current study aims to examine whether strategies of self-reassurance and body-image appreciation mediate the association of feelings of social safeness and acceptance with the "core" dimensions of body and eating-related psychopathology (restraint, eating concern, weight concern, and shape concern), while controlling the effects of body mass index (BMI). Participants were 309 Portuguese women, aged between 18 and 50 years that completed self-report measures. Results from the performed path analysis revealed that self-reassurance and body-image appreciation mediated the impact of feelings of social safeness and acceptance on eating psychopathology- related dimensions. Results seem to suggest that women who perceive the self as acceptable and desirable tend to adopt self-reassurance strategies. These strategies in turn seem to predict a protective and caring relationship with one's own body and decreased severity of eating psychopathology symptoms. This path model explained 22%, 27%, 51%, and 47% of restraint, eating concern, weight concern, and shape concern, respectively, and showed an excellent model fit. Our findings appear to offer significant insights in the field of body and eating-related psychopathology and seem to support the pertinence of creating intervention programs for women from the general community with body and eating-related difficulties that encourage the adoption of self-reassurance strategies and promote a positive and respectful relationship with one's own body image.
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| 14. |
- Oliveira, Sara, et al.
(author)
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Explaining male body attitudes : the role of early peer emotional experiences and shame
- 2018
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In: Eating and Weight Disorders. - : Springer. - 1124-4909 .- 1590-1262. ; 23:6, s. 807-815
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Journal article (peer-reviewed)abstract
- Purpose: The current study tested a path model that examined the association between early emotional experiences with peers and male body attitudes and whether general feelings of shame and body-focused shame mediate this relationship, while controlling for the effect of body mass index.Methods: The sample comprised 241 men from the general community, aged from 18 to 60, who completed an online survey.Results: Correlation analyses showed that the recall of positive early emotional experiences with peers is inversely linked to shame and negative body attitudes. Path analysis results indicated that early emotional experiences with peers had a direct effect on external shame, and an indirect effect on male negative body attitudes mediated by external shame and body-focused shame. Results confirmed the plausibility of the tested model, which accounted for 40% of the variance of male body attitudes. Findings suggested that men who recall fewer positive early peer emotional experiences tend to perceive that they are negatively viewed by others and present more body image-focused shame experiences. This in turn seems to explain a negative self-appreciation of one's muscularity, body fat and height.Conclusions: This study contributes to a better understanding of male body attitudes. Findings suggest that the link between early emotional experiences and male body attitudes may depend on the experience of shame feelings and, particularly, on the extent to which one's body image becomes a source of shame. These data support the relevance of addressing shame experiences when working with men with body image-related difficulties.Level of evidence: Level Vcross-sectional descriptive study.
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| 15. |
- Pinto, Catarina, et al.
(author)
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Social safeness and disordered eating : Exploring underlying mechanisms of body appreciation and inflexible eating
- 2017
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In: Eating and Weight Disorders. - : Springer. - 1124-4909 .- 1590-1262. ; 22:2, s. 303-309
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Journal article (peer-reviewed)abstract
- Feelings of social safeness and connectedness have been associated with adaptive emotion regulation processes and well-being indicators. Further, literature has demonstrated that interpersonal experiences play an important role in the etiology and maintenance of body and eating psychopathology. However, the study of the role of social variables and emotion regulation processes in the engagement in inflexible eating rules and eating psychopathology is still in its early stages. The current study aims to fill some gaps within the literature and explore the mediator role of body appreciation and inflexible eating rules in the link between social safeness and disordered eating. Participants were 253 women, aged between 18 and 50 years old, who completed a series of online self-report measures. Results from the tested path analysis model showed that social safeness holds a significant effect on eating psychopathology, through the mechanisms of body appreciation and inflexible eating rules. Also, results suggested that women who present higher levels of social safeness tend to present a more positive and respectful attitude towards their body and decreased adoption of inflexible eating rules, which seem to explain lower levels of disordered eating behaviours. These findings seem to present empirical support for the development of intervention programs that promote a positive, affectionate and healthy relationship with one's body image, in order to prevent the inflexible adherence to eating rules and disordered eating behaviours.
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| 16. |
- Schwensen, Hanna Ferløv, et al.
(author)
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A systematic review of studies on the faecal microbiota in anorexia nervosa : future research may need to include microbiota from the small intestine
- 2018
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In: Eating and Weight Disorders. - : Springer. - 1124-4909 .- 1590-1262. ; 23:4, s. 399-418
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Research review (peer-reviewed)abstract
- Purpose: Anorexia nervosa (AN) is a poorly understood and often chronic condition. Deviations in the gut microbiota have been reported to influence the gut-brain axis in other disorders. Therefore, if present in AN, it may impact on symptoms and illness progression. A review of the gut microbiota studies in AN is presented.Method: A literature search on PubMed yielded 27 articles; 14 were selected and based on relevance, 9 articles were included. The findings were interpreted in the larger context of preclinical research and clinical observations.Results: 8 out of 9 included studies analysed microbiota from faeces samples, while the last analysed a protein in plasma produced by the gut. Two studies were longitudinal and included an intervention (i.e., weight restoration), five were cross-sectional, one was a case report, and the last was a case series consisting of three cases. Deviations in abundance, diversity, and microbial composition of the faecal microbiota in AN were found.Conclusion: There are currently only a few studies on the gut microbiota in AN, all done on faeces samples, and not all describe the microbiota at the species level extensively. The Archaeon Methanobrevibacter smithii was increased in participants with a BMI < 25 in one study and specifically in AN patients in three studies. Methanobrevibacter smithii may, if detected, be a benchmark biomarker for future studies. We propose that microbiota samples could also be collected from the small intestine, where a major exchange of nutrients takes place and where the microbiota may have a biological impact on AN.
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| 17. |
- Swenne, Ingemar, et al.
(author)
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Bone metabolism in adolescent girls with eating disorders and weight loss : independent effects of weight change, insulin-like growth factor-1 and oestradiol
- 2015
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In: Eating and Weight Disorders. - : Springer Science and Business Media LLC. - 1124-4909 .- 1590-1262. ; 20:1, s. 33-41
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Journal article (peer-reviewed)abstract
- Adolescents with eating disorders (ED) are at risk of developing osteoporosis if weight is not recovered. Previous investigations do not separate the effects of weight change per se from those of concomitant hormonal changes. In this investigation serum osteocalcin (OC), C-terminal telopeptide of collagen (CTX), insulin-like growth factor-1 (IGF-1) and oestradiol were measured at assessment of 498 girls with ED and during weight gain of 59 girls. At assessment, OC concentrations were associated independently with weight (change), IGF-1 and oestradiol. Low weight, a high rate of weight loss and the hormone concentrations were associated with low OC. Low weight and high rate of weight loss were associated with high CTX concentrations but there were no associations independent of weight (change) with the hormones. During weight recovery, OC and CTX were independently and positively associated with weight, weight gain, IGF-1 and oestradiol. Bone metabolism markers are related to weight change independently of IGF-1 and oestradiol during both weight loss and weight gain. During weight gain, when pubertal development and growth are resumed there is an additional independent positive association between the markers and IGF-1 and oestradiol. These relationships are strongest in premenarcheal girls.
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| 18. |
- Wanby, Pär, et al.
(author)
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Increased ferritin levels in patients with anorexia nervosa : impact of weight gain.
- 2016
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In: Eating and Weight Disorders. - : Springer. - 1124-4909 .- 1590-1262. ; 21:3, s. 411-417
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Journal article (peer-reviewed)abstract
- PURPOSE: A few recent studies have found elevated ferritin levels in patients with anorexia nervosa (AN), indicating ferritin as a potential biomarker of disease severity. The purpose of this study was to study how body mass index (BMI) and changes in BMI affect plasma ferritin concentrations in Swedish patients with eating disorders.MATERIALS AND METHODS: In a retrospective computer search from 2009 to 2014, 662 patients with an eating disorder were identified from more than 200,000 individuals with electronic medical records. Three hundred and eighty-nine patients (374 females and 15 males) were found to have at least one p-ferritin value with a corresponding BMI value. Patients with AN were compared to a combined group consisting of patients with bulimia nervosa (BN) and patients with an eating disorder not otherwise specified (EDNOS).RESULTS: Patients with AN had lower BMI compared to the combined group of patients with other eating disorders (BMI = 16.5 ± 1.5, n = 77 vs. 21.0 ± 4.7, n = 312, p < 0.001). Patients with AN also had higher plasma ferritin levels (median 42 μg/L (range 3.3-310) vs. 31 μg/L (range 2.8-280); p < 0.001). As BMI increased in patients with AN, ferritin levels decreased (from a median of 40 μg/L (7-400) to 26 (4-170), n = 47; p < 0.001).DISCUSSION: Measuring ferritin in patients with AN could be valuable in monitoring improvements of nutritional status, but the full clinical value of following ferritin in individual patients has yet to be determined. The study also shows how research can benefit from electronically captured clinical data using electronic health records.
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| 19. |
- Jeskova, Zuzana, et al.
(author)
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In-service and pre-service teacher education in IBSE : The ESTABLISH approach
- 2015
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In: Nuovo Cimento C. - : Soc Italiana Fisica. - 2037-4909. ; 3
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Journal article (peer-reviewed)abstract
- One of the main goals of the ESTABLISH 7fp project (available on line at http://www.establish-fp7.eu/) was the development and implementation of the professional development teacher education programmes (TEP) to support teachers in adopting inquiry-based strategies in their teaching. Within the project there was a model for in-service and pre-service teacher training in IBSE designed and implemented across 12 participating countries. The programme is based on 4 core elements and 4 additional elements that are built around the IBSE teaching units developed within the project. As accepted by ESTABLISH partners, all teacher training programmes include the minimum of the four elements, i.e. introduction to IBSE, industrial content knowledge, teacher as implementer and teacher as developer of IBSE teaching materials. There are also four additional elements designed in detail, i.e. ICT for IBSE, argumentation in the classroom, research and design projects for students, assessment of IBSE. These can be added to the programme optionally with regard to the level of teachers' IBSE skills and current situation in education and teachers' professional development within the country. This ESTABLISH model of TEP was followed in participating countries in order to change teachers' attitudes from traditional ways of teaching towards adopting inquiry strategies and their successful implementation in the classroom. Within the face-to-face workshops teachers experienced and developed their inquiry based teaching strategies using specifically developed materials. In addition, the e-platform has been developed to provide on-line support. This platform provides educators and teachers with all the necessary materials for the training and IBSE teaching units and other teaching materials for teachers' ongoing help. The teacher training programme was successfully implemented in Slovakia. There were two runs of teacher training workshops on IBSE already carried out. Moreover, the additional element ICT in IBSE was developed more deeply designing a separate teacher training course for it. The contribution discusses in more details the success and problems of implementation in the context of Slovak educational environment.
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