The Impact of Alexithymia on Emotion Dysregulation in Anorexia Nervosa and Bulimia Nervosa over Time.

Research supports that anorexia nervosa-restricting subtype (AN-R) and bulimia nervosa (BN) are associated with emotion regulation difficulties and alexithymia. However, the impact of diagnosis on the relationship between these constructs is less well understood. The purpose of the present study was to examine whether eating disorder diagnosis moderated the association between admission alexithymia and emotion regulation through discharge. Adult patients with AN-R (n = 54) and BN (n = 60) completed assessments at treatment admission and discharge from a partial hospital program. Eating disorder diagnosis moderated the association between admission alexithymia levels and change in global emotion dysregulation, impulse control difficulties and access to emotion regulation strategies. At higher levels of admission alexithymia, there were no differences between AN-R and BN on emotion dysregulation, whereas at lower levels of alexithymia, AN-R patients demonstrated lower levels of emotion dysregulation. Results imply that difficulties with alexithymia appear to have a greater impact on emotion dysregulation for AN-R patients. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Psychometric Evaluation and Norms for the Multidimensional Assessment of Interoceptive Awareness (MAIA) in a Clinical Eating Disorders Sample.

Altered interoceptive awareness (IA) has been implicated in the pathophysiology of eating disorders; however, few comprehensive self-report measures of IA exist in eating disorders. The present study sought to validate the Multidimensional Assessment of Interoceptive Awareness (MAIA), originally developed to assess IA in individuals practicing mind-body therapies, in an eating disorder sample. Adult and adolescent patients (n = 376) completed assessments upon admission to a partial hospital programme. Analyses examined the factor structure of the MAIA, scale means, scale-scale correlations, internal consistency and construct validity. Analyses also examined associations between MAIA subscales and eating disorder symptoms. Results supported the original eight-factor structure of the MAIA. Internal consistency was acceptable, and the scales converged with associated measures. Importantly, Not Distracting, Self-regulation, Body Listening and Trusting were most strongly associated with eating disorder symptoms. Results support use of the MAIA among eating disorders and provide further support for the relevance of IA in eating disorders. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Treating Eating Disorders at Higher Levels of Care: Overview and Challenges.

Higher levels of care (HLC)-including inpatient hospitalization, residential treatment, partial hospitalization, and intensive outpatient treatment-are frequently utilized within routine care for eating disorders. Despite widespread use, there is limited research evaluating the efficacy of HLC, as well as clinical issues related to care in these settings. This review describes the different levels of care for eating disorders and briefly reviews the most up-to-date guidelines and research regarding how to choose a level of care. In addition, as HLC approaches for ED continue to be developed and refined, pragmatic and conceptual challenges have emerged that provide barriers to clinical efficacy and the execution of high-quality treatment research. This review includes a discussion of various issues specific to HLC, as well as a summary of recent literature addressing them.

A naturalistic study of fat talk and its behavioral and affective consequences.

Fat talk is a style of verbal expression among young women involving negative self-statements, complaints about physical appearance, and weight management. This research used ecological momentary assessment to examine the impact of naturalistic fat talk experiences on body dissatisfaction, body checking, negative affect, and disordered eating behaviors. We examined trait self-objectification as a moderator. Sixty-five female college students completed a baseline questionnaire and responded to questions when randomly prompted by palm pilot devices for five days. Results indicated fat talk is common and associated with greater body dissatisfaction, body checking, negative affect, and disordered eating behaviors. Fat talk participation was associated with greater body checking than overhearing fat talk. Greater trait self-objectification was associated with greater body dissatisfaction and body checking following fat talk. These results suggest that fat talk negatively impacts the cognitions, affect, and behavior of young women and has increased negative effects for women higher in self-objectification.

Predicting the onset of inappropriate compensatory behaviors in undergraduate college women.

The present study examined various factors from the interactive and sociocultural models of bulimia nervosa as predictors of the onset of compensatory behaviors. Participants (n=237) completed a series of questionnaires assessing dietary restraint, body dissatisfaction, negative affect, binge eating, perfectionism, and self-esteem at two time points one year apart. Women who did not engage in compensatory behaviors at time one but did engage in compensatory behaviors at time two (n=21) were compared to women who engaged in compensatory behaviors at both time points (n=28) and women who did not engage in compensatory behaviors at either time point (n=188). Body dissatisfaction and perfectionism at time one significantly predicted women who began using compensatory behaviors compared to women who did not engage in compensatory behaviors at either time point. Women who experienced an onset of compensatory behaviors also reported significantly greater body dissatisfaction at time 1 than women who engaged in compensatory behaviors for the duration of the study. Implications and limitations of these findings are discussed.

Sex differences in the regulation of serotonergic transmission and behavior in 5-HT receptor knockout mice.

Few studies have examined the relationship between genetics, stress, and sex-linked differences in neurotransmitter systems. Examining serotonin (5-HT) receptor knockout mice on stress-induced behavioral depression, female 5-HT1B receptor knockout mice demonstrated significantly reduced immobility than either male 5-HT1B receptor knockout mice or male and female wild-type mice on the tail suspension test (TST) and forced swimming test. The behavioral phenotype was identified as likely due to a disinhibition of 5-HT release, because depletion of 5-HT with parachlorophenylalanine selectively reduced immobility of female 5-HT1B receptor knockout mice in the TST. In contrast, male and female 5-HT1A receptor knockout mice demonstrated reduced immobility compared with control mice, but the depletion of 5-HT with PCPA did not reverse the antidepressant-like phenotype. Microdialysis studies confirmed significantly higher baseline levels of hippocampal 5-HT in female, but not male, 5-HT1B receptor knockout mice. Both male and female 5-HT1B receptor knockout mice demonstrated augmented dialysate responses to fluoxetine. Also, both male and female 5-HT1B receptor knockout mice demonstrated reductions of immobility in the TST after treatment with fluoxetine. Therefore, female 5-HT1B receptor knockout mice demonstrate a sex-linked disinhibition of 5-HT release that sustained higher baseline levels of hippocampal 5-HT and behavioral vulnerability to 5-HT depletion.

Automated tests for measuring the effects of antidepressants in mice.

The forced swim test (FST) and the tail suspension test (TST) are used widely for measuring the pharmacological effects of antidepressant drugs or changes in stress-evoked behavior in mice. However, inconsistent scoring techniques and poor reproducibility may result from their reliance on subjective ratings by observers to score behavioral changes. In this paper, automated versions of the mouse FST and TST were characterized and validated against observer ratings. For the FST, a commercially available video tracking system (SMART II; San Diego Instruments) measured the duration that mice swam in water-filled cylinders at a set velocity. For the TST, a commercially available automated device (Med Associates, St. Albans, VT) measured input from a strain gauge to detect movements of mice suspended from an elevated bar. Dose-dependent effects of the antidepressant desipramine on FST and TST immobility were measured in CD-1 mice using both automated devices and manual scoring from videotapes. Similar dose-response curves were obtained using both methods. However, a wide range of correlations for raters in the FST indicated that scoring criteria varied for individual raters despite similar instructions. Automated versions of the mouse FST and TST are now available and provide several advantages, including an opportunity to standardize methods across laboratories.

Norepinephrine regulates locomotor hyperactivity in the mouse mutant coloboma.

An imbalance between dopaminergic and noradrenergic systems is implicated in hyperactivity disorders such as attention deficit hyperactivity disorder (ADHD) and Tourette syndrome. We have identified the mouse mutant coloboma as an animal model for examining the neurological basis of hyperactivity. Coloboma mice exhibit spontaneous locomotor hyperactivity that is a result of a reduction in SNAP-25, a presynaptic protein that regulates exocytotic release. These mice exhibit an imbalance in catecholamine regulation whereby brain dopamine (DA) utilization is reduced while norepinephrine (NE) concentrations are significantly increased. Further, calcium-dependent NE release was also increased in these hyperactive mice, despite the reduction in SNAP-25. To determine the role of NE in the expression of hyperactivity, brain NE concentrations were reduced using the specific noradrenergic neurotoxin DSP-4 [N-(2-chloroethyl)-N-ethyl-2-bromobenzylamine hydrochloride]. DSP-4 treatment specifically decreased NE concentrations, but had no effect on brain DA or serotonin. Depletion of NE by DSP-4 through either systemic or central administration significantly reduced the locomotor activity in coloboma mice. These results suggest that NE regulation in the CNS plays an important role in the expression of hyperactivity in this mouse model, consistent with results of human studies and current models of ADHD.