Increasing Warmth in Adolescents with Anorexia Nervosa: A Randomized Controlled Crossover Trial Examining the Efficacy of Mustard and Ginger Footbaths.

OBJECTIVE: To analyze the thermogenic effects of footbaths with medicinal powders in adolescents with anorexia nervosa (AN) in comparison to healthy controls (HCs). Intervention and Outcomes. Forty-one female participants (21 AN, 20 HCs; 14.22 ± 1.54 years) received three footbaths-warm water and mustard (MU, Sinapis nigra), warm water and ginger (GI, Zingiber officinale), or warm water only (WA), in random order within a crossover design. Data were collected before (t1), immediately after foot immersion (maximum 20 minutes) (t2), and after 10 minutes subsequently (t3). Actual skin temperature (high resolution thermography) and perceived warmth (HeWEF questionnaire) were assessed at each time point for various body parts. The primary outcome measure was self-perceived warmth at the feet at t3. Secondary outcome measures were objective skin temperature and subjective warmth at the face, hands, and feet. RESULTS: Perceived warmth at the feet at t3 was significantly higher after GI compared to WA (mean difference -1.02) and MU (-1.07), with no differences between those with AN and HC (-0.29). For the secondary outcome measures, a craniocaudal temperature gradient for the skin temperature (thermography) was noted at t1 for patients with AN and HC (AN with colder feet). The craniocaudal gradient for subjective warmth was only seen for patients with AN. CONCLUSION: Footbaths with ginger increased warmth perception at the feet longer than with mustard or warm water only for adolescents with AN as well as for HC. The impact of ginger footbaths on recovery of thermoregulatory disturbances in patients with AN repeated over extended periods merits further investigation.

Differential caloric intake in overweight females with and without binge eating: effects of a laboratory-based emotion-regulation training.

Negative emotions are among the best predictors for the occurrence of binge eating attacks in binge eating disorder (BED). Evidence from self-report and experimental studies suggests that this link may be mediated by deficits in emotion regulation (ER). Therefore, the aim of the present study was to experimentally test the effects of a short laboratory-based ER training on caloric intake in BED. Thirty-nine women with BED and 42 overweight females without BED were randomly assigned to a laboratory-based ER training focusing on either expressive suppression or cognitive reappraisal. They were then given a negative mood induction with the instruction to adopt the learned ER strategy, which was followed by a bogus taste-test. Independent of group membership, caloric intake was significantly higher in the suppression compared to the reappraisal condition. Furthermore, the BED group displayed significantly higher habitual suppression and significantly lower habitual reappraisal scores than the overweight group. The data suggest that therapeutic interventions focusing on the mediation of more adaptive affect-regulation skills may be useful for the reduction of binge eating episodes.

Risky decision making in adults with ADHD.

BACKGROUND AND OBJECTIVES: Risky decision making and disadvantageous choices constitute core characteristics of patients with attention-deficit/hyperactivity disorder (ADHD). Consequences include negative psychosocial and health-related outcomes. However, risky decision making and its interrelations with emotional states in ADHD are poorly understood. Therefore, the authors investigated risky decision making without and after boredom induction in adults with and without ADHD. METHODS: In study 1, ADHD patients (n = 15) and age/education matched controls (CG; n = 16) were compared on the Game of Dice Task (GDT), an established task measuring decision making in unambiguous situations. In study 2, ADHD patients (n = 14) and CG (n = 13) underwent boredom induction prior to the GDT. RESULTS: In study 1, ADHD patients selected the disadvantageous alternatives significantly more often than CG. In study 2, no significant group differences were found due to an increase in risky decision making in CG following the boredom induction. LIMITATIONS: Even if severity of depression did not affect our results, it may be necessary to compare GDT responses in ADHD patients with and without current depression. CONCLUSIONS: Risk as a motor of disadvantageous decision making needs to be taken into account in therapeutic contexts as a maintenance factor of dysfunctional behaviour. The findings of study 2 are in line with postulated alterations of emotional state adjustment in ADHD. The link between decisions making and emotional regulation in ADHD needs further attention in research.

The impact of an implicit manipulation of self-esteem on body dissatisfaction.

BACKGROUND AND OBJECTIVES: Given the theoretically postulated causal pathway from low self-esteem on body dissatisfaction, the aim of the present study was to experimentally test this linkage before and after a mirror exposure in body dissatisfied females. METHOD: Thirty-six women with high body dissatisfaction (HBD) and 39 women with low body dissatisfaction (LBD) received either a positive or a negative implicit manipulation of self-esteem and participants' actual body dissatisfaction and negative emotions were assessed (T1). Following that, they underwent a one minute mirror exposure and actual body dissatisfaction and emotions were assessed once more (T2). RESULTS: In the HBD group no effects of the self-esteem manipulation were found prior to the mirror exposure. However, the negative manipulation of self-esteem led to a significant increase of body dissatisfaction over the course of the mirror exposure. The positive manipulation of self-esteem did not decrease body dissatisfaction over the course of the mirror exposure. No effects of self-esteem on body dissatisfaction were found in the LBD group. LIMITATIONS: Formal eating disorder diagnosis in study participants was not established. Therefore, the extension of the results to an eating disordered population is recommended. CONCLUSIONS: The results yield evidence of a close linkage between negative self-esteem and body dissatisfaction in individuals high on body dissatisfaction. Consistent with cognitive theories, this link is only apparent when shape and weight schemas are activated, e.g. by the confrontation with one's own body.

Explicit memory bias for positively valenced body-related cues in women with binge eating disorder.

Overweight women with and without binge eating disorder (BED) are characterized by a marked body dissatisfaction, which may in part be due to the negative comments about their weight. Weight-related teasing and discrimination is reported both by healthy overweight women and women with BED, whereas body dissatisfaction is markedly increased among women with BED. Therefore, a memory bias for negatively valenced body-related cues is suspected to occur as a mediating factor in women with BED. In an experimental study, 18 women with BED were compared to 18 overweight healthy female controls (HC) on a free recall task containing four word categories: positively valenced with and without body-related content and negatively valenced with and without body-related content. While both groups showed a bias towards negatively valenced shape-/weight-related words, women with BED retrieved positively valenced shape-/weight-related words significantly less often compared to overweight HC. Findings suggest that it may be the reduced ability to attend to positively valenced shape-/weight-related information, rather than the activation of negative body schemata that differentiates overweight women with BED from overweight women without BED. Results are discussed in the context of cognitive biases in the maintenance of body dissatisfaction.