Identifying specific cues and contexts related to bingeing behavior for the development of effective virtual environments.

BACKGROUND: Binge eating behavior constitutes a central feature of both bulimia nervosa (BN) and binge eating disorder (BED). Cue exposure therapy (CET) has been proposed as an effective intervention. OBJECTIVE: To determine which situations and specific cues trigger higher levels of binge craving and to use the results in the development of virtual reality scenarios in which CET could be applied with BN and BED patients. METHOD: Participants were 101 outpatients, 50 with BED and 51 with BN, according to DSM-5 criteria, and 63 healthy undergraduate students who completed a self-administered questionnaire to assess binge craving. RESULTS: The likelihood of binge craving in the clinical group was greater when alone at home, during the afternoon/early evening and in the late evening/at night, at weekends, and at dinner time or between meals. Higher levels of craving were produced in the kitchen, bedroom, dining room, and bakery situations. With regard to the specific cues reported, the presence of and access to high calorie food and snacks was the most commonly reported cue. Although some gender differences regarding triggering factors were obtained, no statistical differences were observed between ED subtypes. BN and BED patients showed significantly higher levels of binge craving than controls in all the contexts except when feeling positive affect; in this situation, levels of craving were low in both groups. CONCLUSIONS: This information regarding trigger contexts and specific cues can be used to create valid and reliable virtual environments for CET. Indeed, the data from this study may serve to develop a wide range of situations with different levels of binge craving, in which the therapeutic aim is to extinguish conditioned responses and facilitate the generalization of craving extinction.

Development of a VR Application for Binge Eating Treatment: Identification of Contexts and Cues Related to Bingeing Behavior in Spanish Italian Patients.

The objective of this study was to identify frequent situations and specific cues that produce the craving to binge in Spanish and Italian samples of patients with eating disorders (ED). There were two main aims: to assess transcultural differences in the contexts and cues that elicit food craving; and to develop valid, reliable VR environments for effective cue-exposure therapy (CET) for patients from both countries. Twenty-six Spanish and 75 Italian ED patients completed an ad hoc questionnaire to assess contexts and cues that trigger the craving to binge. No differences between groups were found. All patients reported experiencing higher levels of craving in the afternoon/early evening and in the late evening/night, between meals, when alone, and more frequently at the end of the week. Being in the dining room, the kitchen, the bedroom, the bakery and the supermarket were the specific situations that produced the highest levels of craving to binge. We used the questionnaire results to develop a virtual reality application for CET.

Relevancia de Factores de Riesgo, Psicopatología Alimentaria, Insatisfacción Corporal y Funcionamiento Psicológico en Pacientes con TCA / Relevant Risk Factors, Current Eating Psychopathology, Body Shape Concern and Psychological Functioning in Eating Disorders

Objetivo: El primer objetivo del estudio es evaluar restrospectivamente, la relevancia de factores de riesgo en pacientes con Trastorno de la Conducta Alimentaria (TCA) en función de la categoría diagnóstica. El segundo objetivo, es evaluar la psicopatología alimentaria, la insatisfacción corporal y el funcionamiento psicológico en cada grupo diagnóstico. Método: Se evalúa en el momento previo al tratamiento de TCA, un total de 73 pacientes con diferentes criterios diagnósticos: Bulimia Nerviosa Purgativa (BN-P; n=29), la provisional forma diagnóstica del Trastorno por Atracón (TA; n=6), el Trastorno de la Conducta Alimentaria No Especificado tipo Purgativo (TCANE-P; n=17) y el Trastorno de la Conducta Alimentaria No Especificado tipo Restrictivo (TCANE-R; n=21). Resultados: Se hallan como factores de riesgo de consistencia el antecedente de obesidad y el inicio del TCA en la adolescencia. El inicio de la menarquia en la edad temprana no resulta ser un factor de riesgo. El Índice de Masa Corporal (IMC) refleja la sintomatología alimentaria de cada cuadro diagnóstico. El grupo BN-P, se caracteriza por presentar mayor severidad en la sintomatología alimentaria. La mayoría de grupos presenta larga duración de la enfermedad, dificultades en la imagen corporal, el funcionamiento psicosocial y características de personalidad. El sentimiento de ineficacia no fue una característica clínica en casos de TA. Conclusiones: El que los antecedentes de obesidad se hayan mostrado como un factor de riesgo de consistencia en los TCA es un argumento más a favor de la necesidad de su prevención. Las dificultades en el funcionamiento psicosocial encontradas en casos clínicos con TA, avalarían la necesidad de líneas de intervención de tipo más interpersonal en este tipo de pacientes (AU)

Objective: The first aim of this study is a retrospective assessment of relevant risk factors in patients with Eating Disorders (ED). The second aim is to study eating psychopathology, body shape concern and psychological functioning assessment in different groups of eating disorders. Method: Evaluation before intervention of 73 patients with Bulimia Nervosa Purging type (BN-P; n=29), Binge Eating Disorder (BED; n=6), Eating Disorders Not Otherwise Specified Purging type (EDNOS-P; n=17) and Eating Disorders Not Otherwise Specified Restrictive type (EDNOS-R; n=21). Findings: Consistent risk factors in the precedent of obesity and the beginning of the ED in adolescence. The young age at which menarche occurred was not a risk factor. The eating symptomatology of each diagnostic category reflected the nutritional state. The BN-P group presented a more severe eating symptomatology. The majority of the groups had long duration illness and had difficulties with body shape, social performance, and personality problems. The feeling of ineffectiveness was not a clinical characteristic in Binge eating cases. Conclusion: The precedentof obesity showed up as a consolidated risk factor in eating disorders, supporting the necessity of prevention. Difficulties found in social performance in binge eating support the necessity of interpersonal intervention (AU)

Adaptación transcultural al castellano de la Eating Disorder Examination / Cross-cultural adaptation of the Eating Disorder Examination into Spanish

Fundamento y objetivo: Este artículo presenta la adaptación transcultural al castellano de la entrevista semiestructurada Eating Disorder Examination (EDE) de Fairburn y Cooper (1993). Material y método: La versión original fue adaptada al castellano mediante una técnica compleja de traducción-retraducción sucesiva. La versión española final se aplicó a 50 pacientes con trastornos de la conducta alimentaria (17 diagnosticados de anorexia nerviosa, 19 con bulimia nerviosa y 14 con trastorno por atracón) y a 30 sujetos que componían el grupo control. Resultados: Las medias y las desviaciones estándar del grupo en las 4 subescalas son similares a las obtenidas por los estudios normativos con la versión original inglesa. La versión española también muestra coeficientes alfa de Cronbach similares para la fiabilidad. En cuanto a la validez discriminatoria, las subescalas discriminan entre los grupos clínicos y el grupo control de manera significativa. Conclusiones: La versión española de la EDE presenta cualidades psicométricas apropiadas y similares a las de la versión original

Background and objective: This study presents a cross-cultural adaptation into Spanish of the Eating Disorder Examination (EDE) by Fairburn and Cooper (1993). Material and method: The original English version was adapted by means of a complex successive translation-backtranslation procedure. The final Spanish version was then applied to 50 patients with eating disorders (17 diagnosed for anorexia nervosa, 19 for bulimia nervosa, and 14 for binge eating disorder) and to 30 normal control subjects. Results: The means and standard deviations of the group in the 4 subscales were similar to the data obtained by the normative studies of the original English version. The Spanish version also showed similarly high Cronbach alpha coefficients for reliability. As for discriminative validity, the subscales discriminated significantly between the clinical groups and the control group. Conclusions: The Spanish version of the EDE presents adequate psychometric properties, similar to the original version

[Cross-cultural adaptation of the Eating Disorder Examination into Spanish]. / Adaptación transcultural al castellano de la Eating Disorder Examination.

BACKGROUND AND OBJECTIVE: This study presents a cross-cultural adaptation into Spanish of the Eating Disorder Examination (EDE) by Fairburn and Cooper (1993). MATERIAL AND METHOD: The original English version was adapted by means of a complex successive translation-backtranslation procedure. The final Spanish version was then applied to 50 patients with eating disorders (17 diagnosed for anorexia nervosa, 19 for bulimia nervosa, and 14 for binge eating disorder) and to 30 normal control subjects. RESULTS: The means and standard deviations of the group in the 4 subscales were similar to the data obtained by the normative studies of the original English version. The Spanish version also showed similarly high Cronbach alpha coefficients for reliability. As for discriminative validity, the subscales discriminated significantly between the clinical groups and the control group. CONCLUSIONS: The Spanish version of the EDE presents adequate psychometric properties, similar to the original version.

Agorafobia / Agoraphobia

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