Executive dysfunction in eating disorders: Relationship with clinical features.

Eating disorders (ED) are severe mental disorders that may result in significant functional impairment and disability. Neuropsychological studies have consistently found impaired executive function (EF) among ED patients. EF is particularly involved in fundamental skills of daily living and in behavioral and emotional regulation. In this study, impairment of executive functioning is investigated in patients with eating disorders and the associations with clinical features and clinical subtypes are analyzed. METHOD: 75 female patients (m = 22.01 years, sd = 9.15) with eating disorder (43 restrictive anorexia, 30 binge-eating anorexia and 13 bulimia nervosa) and 37 healthy controls (m = 18.54 years, sd = 4.21) were included in the study. An extensive assessment of executive function domains (verbal fluency, set shifting, attention span, selective attention, working memory, inhibitory control and processing speed) was carried out in both groups. Clinical scales for food intake restriction, binge-eating/purging, depression, anxiety and impulsivity were also administered and correlated with scores on executive function tests. RESULTS: Patients with an ED had significantly lower scores than healthy controls in performance of several executive function tests, particularly in set shifting, interference control and processing speed (p < .01, in all three domains). Executive function impairment was related to anxious, depressive and eating disorder symptoms (p < .05), regardless of clinical subtype. CONCLUSIONS: Executive function impairment in eating disorders is associated with greater ED symptomatic severity and might involve a negative treatment outcome. Therefore, cognitive remediation techniques should probably be considered in a number of severe patients with ED.

Weight-Teasing and Eating Disorders-A Comparative Study in Adolescent and Adult Samples.

Disordered eating, unhealthy weight-control behaviours and body dissatisfaction are associated with diminished mental health. A key aspect that has been identified for the development of disordered eating behaviours and body dissatisfaction is to be teased. Additionally, the literature suggests that weight may affect the relationship between weight-teasing and disordered eating and body dissatisfaction, although this pattern is unclear. This study presents two cross-sectional studies with an adult and an adolescent sample. The adolescent sample comprised 15,224 participants, and the adult sample comprised 321 participants, all from Spain. Hierarchical regression analyses were conducted. Aims: to assess the relations among disordered eating, body dissatisfaction, weight, and weight-teasing among adolescents and adults; and to examine whether weight-teasing, weight, age, and gender predict disordered eating and body dissatisfaction in adults and adolescents. The results showed that adolescent girls presented greater effects, and all interactions were significant between weight-teasing and eating disorders. Adults also showed greater effects for women, and only eating disorder interactions were significant. Weight-control behaviours did not show any relationship with weight-teasing. Conclusion: Different approaches may be used in the prevention of eating disorders. Our results show that weight-teasing affects adults differently from adolescents.

Marchiafava-Bignami disease in a patient with schizophrenia and alcohol use disorder.

Substance-related disorders are the most frequent comorbidity in schizophrenia. Concretely, alcohol is the most commonly consumed substance after tobacco. Patients with schizophrenia with this comorbidity have a worse clinical course and can develop serious neuropsychiatric complications. One of them, Marchiafava-Bignami disease (MBD) can be incorrectly diagnosed as a decompensation of their mental disorder.

NOTA CLÍNICA: Enfermedad deMarchiafava-Bignami en un paciente con esquizofrenia y trastorno por uso de alcohol / CLINICAL NOTE: Marchiafava-Bignami disease in a patient with schizophrenia and alcohol use disorder

Introducción: Los trastornos por abuso de sustancias sonla comorbilidad más frecuente en la esquizofrenia, siendo elalcohol, concretamente, la sustancia más frecuentementeconsumida tras el tabaco. Los pacientes con esquizofreniaque presentan esta comorbilidad presentan una peor evolución clínica y pueden desarrollar graves complicaciones neuropsiquiátricas. Una de ellas, la enfermedad de Marchiafava-Bignami (EMB), puede ser erróneamente diagnosticadacomo una descompensación del trastorno mental, conllevando graves consecuencias.Método. Se presenta el caso de un varón de 51 años,diagnosticado de esquizofrenia y trastorno por consumode alcohol. Experimentó síntomas neuropsiquiátricos agudos por los que se sospechó una descompensación de suesquizofrenia. Dada la presentación clínica atípica y susantecedentes médicos, se sospechó una patología orgánicay se realizó una prueba de imagen cerebral en la que sediagnosticó una EMB.Conclusiones. La EMB es una entidad clínica infrecuenteque debe formar parte del diagnóstico diferencial en pacientes con trastorno por consumo de alcohol que experimenten síntomas neuropsiquiátricos atípicos. (AU)

Introduction: Substance-related disorders are the mostfrequent comorbidity in schizophrenia. Concretely, alcohol isthe most commonly consumed substance after tobacco. Patients with schizophrenia with this comorbidity have a worseclinical course and can develop serious neuropsychiatriccomplications. One of them, Marchiafava-Bignami disease(MBD) can be incorrectly diagnosed as a decompensation oftheir mental disorder.Methods. A case of a 51-year-old man, diagnosed withschizophrenia and alcohol use disorder is presented. He experienced acute neuropsychiatric symptoms for which schizophrenia decompensation was suspected. Based on his atypical symptoms and medical history, a brain imaging test wasperformed and MBD was diagnosed.Conclusions. MBD is an infrequent clinical entity thatshould be part of differential diagnosis in patients with alcohol abuse disorder experiencing atypical neuropsychiatricsymptoms. (AU)

Attitudes towards change mediate the effect of dissociation on psychopathological outcome in the treatment of eating disorders.

OBJECTIVES: The study aimed to examine whether dissociation and attitudes towards change were associated with the psychopathology in patients with eating disorders (EDs) at 1-year follow-up. METHOD: The study included 110 females with anorexia nervosa and bulimia nervosa (48 and 62 respectively). At the beginning of the study and 1 year later, they were assessed by means of the following questionnaires: Dissociative Experiences Scale, Attitudes Towards Change (ACTA), State-Trait Anxiety Inventory, Rosenberg Self-Esteem Scale, Beck Depression Inventory, Eating Attitude Test, Bulimic Investigatory Test Edinburgh and Body Shape Questionnaire (BSQ). RESULTS: No statistically significant differences were found between both diagnostic groups regarding dissociation scores. The ACTA at baseline, specifically for patients in the contemplation stage, mediate the effect of dissociation on the psychopathological outcome. DISCUSSION: These findings suggest that dissociation might be a transdiagnostic feature related to the EDs outcome. The psychotherapeutic framework must take it into account, particularly in patients in the contemplation stage.

Is Small Still Beautiful for the Strengths and Difficulties Questionnaire? Novel Findings Using Exploratory Structural Equation Modeling.

During the present decade a large body of research has employed confirmatory factor analysis (CFA) to evaluate the factor structure of the Strengths and Difficulties Questionnaire (SDQ) across multiple languages and cultures. However, because CFA can produce strongly biased estimations when the population cross-loadings differ meaningfully from zero, it may not be the most appropriate framework to model the SDQ responses. With this in mind, the current study sought to assess the factorial structure of the SDQ using the more flexible exploratory structural equation modeling approach. Using a large-scale Spanish sample composed of 67,253 youths aged between 10 and 18 years (M = 14.16, SD = 1.07), the results showed that CFA provided a severely biased and overly optimistic assessment of the underlying structure of the SDQ. In contrast, exploratory structural equation modeling revealed a generally weak factorial structure, including questionable indicators with large cross-loadings, multiple error correlations, and significant wording variance. A subsequent Monte Carlo study showed that sample sizes greater than 4,000 would be needed to adequately recover the SDQ loading structure. The findings from this study prevent recommending the SDQ as a screening tool and suggest caution when interpreting previous results in the literature based on CFA modeling.

The role of attentional biases to appetitive stimuli in childhood overweight.

Overweight during childhood constitutes a high-risk factor for adult obesity. An abnormal attention to food stimuli (i.e., a bias) has been suggested as an underlying mechanism to the onset and/or maintenance of obesity. Previous literature supports the existence of a biased attention toward food stimuli in adults with obesity. However, it is unknown whether this attentional bias occurs in high-risk children for adult obesity. We aimed to examine attentional biases to food at different stages of attention processing in overweight children. A dot-probe task was applied to 25 children with overweight and 25 healthy-weight children (8-12 years old). Attentional preference to or avoidance of pleasant food stimuli, which were displayed simultaneously with pleasant non-food stimuli (matched in valence and arousal), was examined at 100-ms (initial visual orienting), 500-ms (attention engagement), and 1500-ms (maintained attention) presentation rates. Both children with overweight and healthy-weight children showed an attentional bias toward food images at a 100-ms presentation rate. However, unlike healthy-weight children, those with overweight showed an attentional preference toward food images at 500- and 1500-ms presentation rates. A biased initial orienting to food cues can be found regardless of weight. However, a biased attention engagement and a biased maintained attention toward food cues are characteristics of children with overweight. Therefore, as in adults, children at risk of adult obesity have an abnormal attentional processing of food stimuli.

Prevalence of alexithymia in eating disorders in a clinical sample of 800 Mexican patients.

INTRODUCTION: The inability to identify, express feelings, and not distinguish between emotions and bodily sensations, is known as alexithymia. In 1988, it developed The Toronto Alexithymia Scale (TAS-20), consists of 20 items and three factors: a) difficulty of identifying feelings and differences between feelings and bodily sensations; b) difficulty of describing feelings; and c) externally oriented thinking. It's considered that people with eating disorders have specific deficits in identify and communicate their feelings. OBJECTIVE: The present study has as purpose to the instrument validation. METHODS: It was a cross-sectional study and psychometric character design of a single sample, formed of 435 persons suffering eating disorder (ED), with an age range of 12-68 years, of which 91% were women and 9% were men. To obtain the reliability of the instrument, applies internal consistency test, which resulted in an alpha of 0.89, then applied a factor analysis of principals components with oblimin rotation. RESULTS: According to statistical analysis, were eliminated six items, so the scale finished with 14 items, and to analyze it observed that these items correspond with the two main factors of the original scale. The ED patients present alexithymia. DISCUSSION: The scale satisfies the criteria of validity necessary for use in this population.

INTRODUCCIÓN: La incapacidad para identificar y expresar sentimientos, y no distinguir entre las emociones y las sensaciones corporales, se conoce como alexitimia. En 1988 se desarrolló la Escala de Alexitimia de Toronto (TAS-20), que está conformada por 20 reactivos y tres factores: a) dificultad para identificar los sentimientos y las diferencias entre sentimientos y sensaciones corporales; b) dificultad para describir sentimientos; y c) pensamiento orientado externamente. Se considera que las personas con trastornos de la conducta alimentaria (TCA) tienen déficits específicos en la identificación y la comunicación de sus sentimientos. OBJETIVO: Realizar la validación de dicho instrumento. MÉTODO: Estudio de tipo transversal y de carácter psicométrico con diseño de una sola muestra, conformada por 435 personas con diagnóstico de TCA, con un rango de edad de 12 a 68 años, de las cuales el 91% eran mujeres y el 9% eran hombres. Para obtener la confiabilidad del instrumento se aplicó una prueba de consistencia interna, que dio como resultado un alfa de 0.89; posteriormente se hizo un análisis factorial de componentes principales con rotación oblimin. RESULTADOS: De acuerdo con el análisis estadístico, se eliminaron seis reactivos, de tal forma que la escala finalizó con 14 reactivos, y al analizarlos se observó que concordaban con los dos factores principales de la escala original. Las pacientes con TCA presentan alexitimia. DISCUSIÓN: La escala satisface los criterios de validez necesarios para ser utilizada en dicha población.

Changes in genetic and environmental influences on disordered eating between pre-menarche and postmenarche girls. A twin study.

significantly increase during puberty. The goal of this research is to evaluate changes during puberty which could have genetic and environmental influences on a broad spectrum of disordered eating attitudes and behaviors. Methods. Participants were 158 pairs of adolescent female twins, categorized in two groups according to menarche stage (pre or post). ED measures: Disordered eating attitudes and behaviors were assessed by means of the Children’s Eating Attitudes Test and four sub-scales of the Eating Disorders Inventory: Drive for thinness, Body dissatisfaction, Ineffectiveness, and Perfectionism. Intra-class correlations in monozygotic (MZ) and dizygotic (DZ) twins were calculated separately in premenarche and premenarche group for each ED subscale Results. 48 premenarche twins (30 MZ twins and 18 DZ twins) and 110 premenarche twins (66 MZ and 44 DZ twins) were included. The intra-class correlations suggested no genetic influence on the total ChEAT score of participants at the premenarche stage. For the premenarche participants, however, sources of variance suggested a very high heritability. Regarding the EDI sub-scales, only the trait “Ineffectiveness” exhibited a moderate heritability among premenarche subjects, while all the four eating sub-scales showed moderate heritability estimates in the premenarche stage group. Conclusions. Our findings reveal that there are significant differences in genetic and environmental effects on eating attitudes and behaviors depending on being in a premenarche or premenarche stage. Therefore, clinicians should pay attention to female adolescents at high risk of developing ED, especially during the critical period of menarche.

Cambios en la influencia genética y ambiental en los trastornos de la alimentación entre niñas en estadio pre y post menarquia. Un estudio gemelar / Changes in genetic and environmental influences on disordered eating between pre-menarche and post-menarche girls. A twin study

Introducción. La incidencia y heredabilidad de los trastornos de la conducta alimentaria (TCA) se incrementa durante la pubertad. El objetivo de la presente investigación fue evaluar los cambios en las influencias genéticas ambientales sobre un amplio espectro de actitudes y conductas alimentarias anómalas durante la pubertad. Metodología. participaron 160 parejas de gemelas adolescentes, que se categorizaron en dos grupos en función del estado de menarquia (pre y pos). Medidas de TCA: Las actitudes y conductas alimentarias anómalas fueron evaluadas mediante el ChEAT (Children's Eating Attitudes Test) y cuatro subescalas del EDI (Eating Disorders Inventory); Impulso a la delgadez, Insatisfacción corporal, Ineficacia y Perfeccionismo. Las correlaciones intrapareja en gemelas MZ (monozigotas) y DZ (dizigotas) se calcularon por separado en los grupos de premenarquia y posmenarquia para cada medida de TCA. Resultados. Cuarenta y ocho gemelas premenarquia (30 MZ y 18 DZ) y 110 gemelas posmenarquia (66 MZ y 44 DZ). Las correlaciones sugirieron que no hay una influencia genética en la puntuación total del ChEAT en las niñas en estado premenarquia, mientras que en las niñas posmenarquia el porcentaje de la varianza para las influencias genéticas es elevado. En relación a las subescalas del EDI, únicamente la variable "Ineficacia" mostró una moderada heredabilidad en las niñas en estadio premenarquia, mientras que las cuatro actitudes alimentarias mostraron una moderada heredabilidad en el grupo de niñas posmenarquia. Conclusiones. Nuestro abordaje revela cambios significativos relacionados con la menarquia en las contribuciones de las influencias genéticas y ambientales sobre las conductas y actitudes alimentarias anómalas. Los clínicos deberían centrar su atención en las niñas adolescentes con alto riesgo de desarrollar TCA especialmente durante el periodo crítico de la menarquia

Background. Eating disorders' incidence and heritability significantly increase during puberty. The goal of this research is to evaluate changes during puberty which could have genetic and environmental influences on a broad spectrum of disordered eating attitudes and behaviors. Methods. Participants were 158 pairs of adolescent female twins, categorized in two groups according to menarche stage (pre or post). ED measures: Disordered eating attitudes and behaviors were assessed by means of the Children's Eating Attitudes Test and four sub-scales of the Eating Disorders Inventory: Drive for thinness, Body dissatisfaction, Ineffectiveness, and Perfectionism. Intra-class correlations in monozygotic (MZ) and dizygotic (DZ) twins were calculated separately in premenarche and premenarche group for each ED subscale Results. 48 premenarche twins (30 MZ twins and 18 DZ twins) and 110 premenarche twins (66 MZ and 44 DZ twins) were included. The intra-class correlations suggested no genetic influence on the total ChEAT score of participants at the premenarche stage. For the premenarche participants, however, sources of variance suggested a very high heritability. Regarding the EDI sub-scales, only the trait "Ineffectiveness" exhibited a moderate heritability among premenarche subjects, while all the four eating sub-scales showed moderate heritability estimates in the premenarche stage group. Conclusions. Our findings reveal that there are significant differences in genetic and environmental effects on eating attitudes and behaviors depending on being in a premenarche or premenarche stage. Therefore, clinicians should pay attention to female adolescents at high risk of developing ED, especially during the critical period of menarche

Prevalence of alexithymia in eating disorders in a clinical sample of 800 Mexican patients. / Prevalencia de alexitimia en los trastornos de la conducta alimentaria en una muestra clínica de 800 pacientes mexicanas

Introduction: The inability to identify, express feelings, and not distinguish between emotions and bodily sensations, is known as alexithymia. In 1988, it developed The Toronto Alexithymia Scale (TAS-20), consists of 20 items and three factors: a) difficulty of identifying feelings and differences between feelings and bodily sensations; b) difficulty of describing feelings; and c) externally oriented thinking. It's considered that people with eating disorders have specific deficits in identify and communicate their feelings. Objective: The present study has as purpose to the instrument validation. Methods: It was a cross-sectional study and psychometric character design of a single sample, formed of 435 persons suffering eating disorder (ED), with an age range of 12-68 years, of which 91% were women and 9% were men. To obtain the reliability of the instrument, applies internal consistency test, which resulted in an alpha of 0.89, then applied a factor analysis of principals components with oblimin rotation. Results: According to statistical analysis, were eliminated six items, so the scale finished with 14 items, and to analyze it observed that these items correspond with the two main factors of the original scale. The ED patients present alexithymia. Discussion: The scale satisfies the criteria of validity necessary for use in this population.

Introducción: La incapacidad para identificar y expresar sentimientos, y no distinguir entre las emociones y las sensaciones corporales, se conoce como alexitimia. En 1988 se desarrolló la Escala de Alexitimia de Toronto (TAS-20), que está conformada por 20 reactivos y tres factores: a) dificultad para identificar los sentimientos y las diferencias entre sentimientos y sensaciones corporales; b) dificultad para describir sentimientos; y c) pensamiento orientado externamente. Se considera que las personas con trastornos de la conducta alimentaria (TCA) tienen déficits específicos en la identificación y la comunicación de sus sentimientos. Objetivo: Realizar la validación de dicho instrumento. Método: Estudio de tipo transversal y de carácter psicométrico con diseño de una sola muestra, conformada por 435 personas con diagnóstico de TCA, con un rango de edad de 12 a 68 años, de las cuales el 91% eran mujeres y el 9% eran hombres. Para obtener la confiabilidad del instrumento se aplicó una prueba de consistencia interna, que dio como resultado un alfa de 0.89; posteriormente se hizo un análisis factorial de componentes principales con rotación oblimin. Resultados: De acuerdo con el análisis estadístico, se eliminaron seis reactivos, de tal forma que la escala finalizó con 14 reactivos, y al analizarlos se observó que concordaban con los dos factores principales de la escala original. Las pacientes con TCA presentan alexitimia. Discusión: La escala satisface los criterios de validez necesarios para ser utilizada en dicha población.

Blunted cortisol response to stress in patients with eating disorders: Its association to bulimic features.

OBJECTIVE: Clinical research on cortisol response to stress in patients with eating disorders has provided controversial and even contradictory results. As this might be the consequence of the inclusion in the studies of heterogeneous clinical populations, 3 highly selected samples were studied. METHODS: Dexamethasone suppression test was performed on 15 restricting anorexia nervosa patients without history of bulimia nervosa (BN), 17 BN patients with normal weight and no history of anorexia nervosa, and 22 healthy controls. Three days later, the Trier Social Stress Test was applied, and 8 saliva samples were collected along the trial for cortisol assessment. RESULTS: When the patients were considered as a single group, a slightly blunted cortisol response to stress was observed, but when the 3 groups were considered separately, the blunted response was observed only in the BN patients. DISCUSSION: The results support the association between blunted cortisol response and bulimic features.

Hypoesthesia in generalised anxiety disorder and major depression disorder.

Objective: The determination of soft signs can be a conducive practice to understand the differential etiology between depression and anxiety. This study aims at examining malleolar hypoesthesia role in distinguishing between patients with generalised anxiety disorder (GAD) and major depression disorder (MDD). Methods: This study examines the presence of malleolar hypoesthesia in patients with GAD (n = 47) compared to patients with MDD (n = 48) and healthy individuals (controls; n = 99). The Wartenberg wheel, a medical device for neurological use, was employed to determine the presence of hypoesthesia on both sides of the ankles. Results: The data revealed: i) MDD patients showed higher hypoesthesia than GAD patients (p = .008), ii) participants with hypoesthesia had higher anxiety and depression scores than participants without hypoesthesia (all p < .001) and iii) logistic regression model indicated that hypoesthesia can be a predictor of MDD relative to GAD diagnosis (Odds Ratio: 17.43 (1.40-217.09; p = .026)). Conclusions: Malleolar hypoesthesia was higher in MDD than GAD. The detection of hypoesthesia may help to investigate the differential etiology between MDD and GAD diagnosis.

Validación de la Escala Hospitalaria de Ansiedad y Depresión en población mexicana con trastorno de la conducta alimentaria / Validation of the Hospital Anxiety and Depression Scale in Mexican population with eating disorders

Resumen Los trastornos de la conducta alimentaria (TCA) son trastornos mentales caracterizados por la alteración del patrón de ingesta calórica. A su vez, los TCA presentan una alta comorbilidad con la depresión y la ansiedad. En México, la Escala Hospitalaria de Ansiedad y Depresión (HADS) ha mostrado ser un instrumento de evaluación válido y confiable en pacientes con VIH, cáncer u obesidad, pero no se han examinado sus propiedades psicométricas en pacientes con TCA, siendo este el objetivo del presente trabajo. Participaron 325 pacientes (M edad = 22.0, DE =9.7), quienes completaron la HADS. Con base en el análisis de componentes principales, con rotación oblimin, la escala quedó conformada por 12 reactivos divididos en las dos subescalas predichas: Depresión (con nueve ítems) y Ansiedad (con tres ítems). Con base en esta estructura, se confirmó la consistencia interna tanto de la escala (α = 0.88) como de sus dos subescalas (α > 0.80). Sin embargo, los reactivos no se agruparon de forma similar a la escala original, por lo que se analiza en detalle la reconfiguración de la HADS a la luz de las características de la población con TCA en que se examinó la escala.

Abstract Eating disorders (ED) are psychiatric diseases characterized by the alteration of the caloric intake. Besides, ED have a high comorbidity with depression and anxiety. In Mexico, the Hospital Anxiety and Depression Scale (HADS) has shown to be a valid and reliable instrument in patients with HIV, cancer, and obesity but its psychometric properties have not been assessed in patients with ED, being the latter the aim of this research. A total of 325 patients (M age = 22.0, SD = 9.7), completed the HADS. Based on principal axis factoring and oblimin rotation the scale yielded 12 items divided into two subscales: Depression (with nine items) and Anxiety (with three items). With this structure was confirmed the internal consistency of the scale (α = 0.88) and the two subscales (α > 0.80), however the items did not group in the same order than they did in the original scale, for this reason the new configuration of the HADS was analyzed in detail based on the features of the population where the scale was examined, this means, in patients with ED.

Influencias genéticas y ambientales en rasgos psicológicos y actitudes alimentarias en una población escolar española / Genetic and environmental influences on psychological traits and eating attitudes in a sample of Spanish schoolchildren

Introducción. La heredabilidad de los trastornos de la conducta alimentaria, como la anorexia nerviosa y la bulimia nerviosa, se ha estimado alrededor del 22% al 62%. El objetivo del presente trabajo es determinar la influencia de los factores genéticos y ambientales que contribuyen en la expresión de los factores psicológicos medidos a través del Eating Disorders Inventory, en función del sexo, en adolescentes de la Comunidad Valenciana (España). Material y métodos. Quinientas ochenta y cuatro parejas de gemelos de 13 a 18 años de edad. Para determinar la cigosidad los profesores rellenaron un cuestionario de similitud física. Se aplicaron las subescalas del Eating Disorders Inventory, impulso a la delgadez, insatisfacción corporal, perfeccionismo e ineficacia. Se ha realizado una modelización de las mismas para establecer los componentes genéticos y ambientales (comunes y específicos) de su varianza. Resultados. En las niñas las 4 variables mostraron un componente de heredabilidad, del 37,7% para la ineficacia, del 42,8% para el perfeccionismo, del 56,9% para el impulso a la delgadez y del 65,5% para la insatisfacción corporal. En los niños se descarta una influencia genética para la insatisfacción corporal, que aparece influenciada exclusivamente por factores ambientales. El resto de variables mostraron un componente heredable, pero en menor medida que en las niñas. Conclusiones. A excepción de la IC en niños, las actitudes y comportamientos alimentarios muestran un patrón parcialmente heredable, que varía en función del sexo (AU)

Introduction. The heritability of eating disorders has been estimated to range from 22% to over 62%.The aim of this study is to determine the relative influence of genetics and environment that contribute to the drive for thinness, body dissatisfaction, perfectionism, and ineffectiveness, by evaluating sex differences in a sample of adolescent twins from Valencia, Spain. Material and methods. Five hundred eighty-four pairs of adolescent twins between 13 and 18 years of age completed the study. To determine zygosity, teachers responded to a questionnaire on physical similarity. Psychological traits of eating disorders were assessed with four sub-scales of the Eating Disorder Inventory (EDI); drive for thinness, body dissatisfaction, perfectionism, and ineffectiveness. Twin models were used to assess genetic and environmental (common and unique) factors affecting these four psychological traits. Results. All four traits showed significant genetic contributions among girls, with heritability estimates of 37.7% for ineffectiveness, 42.8% for perfectionism, 56.9% for drive for thinness, and 65.5% for body dissatisfaction. Among boys, body dissatisfaction showed no additive genetic contributions, indicating significant shared and individual specific environment effects. The three other traits in boys showed significant additive genetic contributions, but were lower than in girls. Conclusions. With the exception of body dissatisfaction in boys, psychological traits of eating disorders show heritability patterns that differ according to sex (AU)

Genetic and environmental influences on psychological traits and eating attitudes in a sample of Spanish schoolchildren. / Influencias genéticas y ambientales en rasgos psicológicos y actitudes alimentarias en una población escolar española.

INTRODUCTION: The heritability of eating disorders has been estimated to range from 22% to over 62%.The aim of this study is to determine the relative influence of genetics and environment that contribute to the drive for thinness, body dissatisfaction, perfectionism, and ineffectiveness, by evaluating sex differences in a sample of adolescent twins from Valencia, Spain. MATERIAL AND METHODS: Five hundred eighty-four pairs of adolescent twins between 13 and 18 years of age completed the study. To determine zygosity, teachers responded to a questionnaire on physical similarity. Psychological traits of eating disorders were assessed with four sub-scales of the Eating Disorder Inventory (EDI); drive for thinness, body dissatisfaction, perfectionism, and ineffectiveness. Twin models were used to assess genetic and environmental (common and unique) factors affecting these four psychological traits. RESULTS: All four traits showed significant genetic contributions among girls, with heritability estimates of 37.7% for ineffectiveness, 42.8% for perfectionism, 56.9% for drive for thinness, and 65.5% for body dissatisfaction. Among boys, body dissatisfaction showed no additive genetic contributions, indicating significant shared and individual specific environment effects. The three other traits in boys showed significant additive genetic contributions, but were lower than in girls. CONCLUSIONS: With the exception of body dissatisfaction in boys, psychological traits of eating disorders show heritability patterns that differ according to sex.

Is Hypoesthesia of the Malleolus a Subtle Neurological Sign in Anxiety?

This study examined the presence of neurological soft signs, an accessible diagnostic instrument, in patients with anxiety. Individuals with anxiety were more likely to manifest hypoesthesia than healthy controls, and patients who showed hypoesthesia exhibited greater symptoms of anxiety and depression.

Genetic and environmental contributions to perfectionism and its common factors.

UNLABELLED: The aims of this study: (1) To evaluate the relative contributions of genetics and environment to perfectionism and it's two constructs: self-oriented, and socially prescribed perfectionism. (2) To clarify genetic and environmental common origins of both personal and social components. METHODS: Participants were 258 pairs of adolescent Spanish twins. Socially prescribed and self-oriented perfectionism were assessed using the perfectionism subscale of the Eating Disorder Inventory. STATISTICS: univariate and bivariate twin models, according to sex. Results; Heritability of self-oriented perfectionism was 23% in boys and 30% in girls, and of socially prescribed perfectionism 39% in boys and 42% in girls. Bivariate analysis suggested a common genetic and environmental pathway model. The genetic correlation between both perfectionisms was 0.981 in boys and 0.704 in girls. The non-shared environmental correlation was 0.254 in boys and 0.259 in girls. Conclusions; genetic influences on perfectionism are moderate during adolescence. Our results point toward a shared genetic component underlying both kind of perfectionism. These findings generate doubts about the hypothesis of a leading role of genetics in the pathogenesis of Self-oriented perfectionism and of environment in socially prescribed. The high genetic correlation seems to indicate that self-oriented and socially prescribed are the same dimension of perfectionism.

Influencias genéticas y ambientales sobre el índice de masa corporal en una población española adolescente gemelar / Genetic and environmental contributions to body mass index in a Spanish adolescent twin sample

Fundamento y objetivo: Los estudios familiares y gemelares han demostrado que los factores genéticos son responsables del 47-90% de la variancia interindividual del índice de masa corporal (IMC). El objetivo de la presente investigación fue evaluar los factores genéticos y ambientales que contribuyen a las diferencias en el IMC, y en función del sexo, en una muestra gemelar de escolares de la Comunidad Valenciana. Material y método: Quinientas ochenta y cuatro parejas de gemelos de 13 a 18 años de edad completaron el estudio: 82 parejas monocigóticas (MC) y 87 dicigóticas (DC) varones, 118 (MC) y 102 (DC) mujeres, y 195 parejas (DC) de sexo opuesto. Para determinar la cigosidad, los profesores rellenaron un cuestionario de similitud física y pesaron y tallaron a los participantes. Se calculó el IMC y se estableció el estado nutricional según la edad. Se llevó a cabo una modelización del IMC que permitió establecer los componentes genéticos y ambientales (comunes y específicos) de su variancia. Resultados: Se observó un 7,1% de sobrepeso y un 2,8% de obesidad. La heredabilidad del IMC se estimó en un 88% en niños y en un 72,1% en niñas. Los factores ambientales específicos explicaron el resto de la variancia del IMC (en niños el 12% y en niñas el 8,8%). Solo en las niñas apareció una contribución de los factores ambientales comunes. Conclusiones: La influencia genética sobre el IMC es intensa durante la adolescencia, con ligeras variaciones en función del sexo, siendo solo las niñas vulnerables a las influencias ambientales comunes (AU)

Background and objective: Twin and family studies support large genetic influences on variability in body mass index (BMI), with heritability estimates ranging from 47% to over 90%. Our objective was to study the relative contributions of genetics and environment to BMI, evaluating sex differences, in an adolescent twin sample from Valencia, Spain. Material and methods: Five hundred eighty-four pairs of adolescent twins between 13 and 18 years of age completed the study (82 monozygotic [MZ] and 87 dizygotic [DZ] pairs of male twins, 118 MZ and 102 DZ pairs of female twins, and 195 opposite-sex pairs of DZ twins). To determine zygosity, teachers responded a questionnaire on physical similarity. They also measured the participant's height and weight. BMI was calculated and weight status was determined according to age. We used twin models to assess genetic and environmental (common and unique) factors affecting BMI. Results: There was a 7.1% frequency of overweight and 2.8% of obesity. The estimated heritability of BMI was 88.0% in boys and 72.1% in girls, with the remaining variance attributable to non-shared environment in boys (12.0%) and 8.8% in girls. It was only in girls that common environment had an effect on BMI. Conclusions: Genetics appears to play an important role in explaining the variability in BMI in the adolescence, with slight variations between boys and girls. Common environmental factors exert their influence on BMI only in girls (AU)

Relación entre la percepción de la crianza y la psicopatología alimentaria / Parental rearing and eating psychopathology

Introducción. El objetivo de nuestro trabajo es identificar cómo los recuerdos de la crianza podrían influir en la expresión clínica de los trastornos de la conducta alimentaria (TCA). Metodología. Administramos una batería de cuestionarios de psicopatología general (BDI, STAI, RSE) y alimentaria (EAT, EDI-2, BITE, BSQ) a 196 pacientes diagnosticados de TCA y a 127 sujetos sanos reclutados de la Escuela de Enfermería. Todos completaron también un cuestionario sobre ‘Los recuerdos de mi crianza’ (EMBU) y una encuesta de variables familiares. Resultados. En relación al grupo control, los pacientes con un TCA percibían mayor rechazo, sobreprotección y menor afecto que los controles. En el grupo de pacientes, el favoritismo paterno, la sobreprotección materna e inversamente el afecto paterno se relacionaba con la ansiedad estado y rasgo. El afecto paterno, junto al rechazo, la sobreprotección y el favoritismo maternos, también se relacionaba inversamente con la autoestima. Respecto a la psicopatología alimentaria, el rechazo corporal se relacionaba inversamente con afecto paterno y favoritismo materno. La ineficacia, perfeccionismo y ascetismo del EDI con el rechazo global y el rechazo materno con la tendencia a la delgadez, conciencia interoceptiva e impulsividad. El afecto global con perfeccionismo. La subescala bulimia y las puntuaciones del BITE se relacionaban inversamente con sobreprotección paterna y afecto paterno y directamente con favoritismo paterno y rechazo global. Conclusiones. La percepción de la crianza difiere en los subtipos de TCA. Pacientes con bulimia o TCA no especificado recordaban mayor rechazo, menor afecto y mayor sobreprotección que pacientes con anorexia y controles

Introduction. The aim of this study was to identify the relationship between perceived rearing styles and the clinical expression of Eating Disorders (ED). Methods. One hundred and ninety-six patients diagnosed of an ED and 127 healthy student as controls selected from the Nursing College were evaluated for general psychopathology (STAI, BDI II, RSE), and for abnormal eating attitudes (EAT, EDI-II, BITE). The EMBU (‘my memories of upbringing’) was administered for the assessment of perceived parental rearing styles and we used a questionnaire to assess familial variables. Results. In relation to the control group, patients with ED perceived greater rejection, overprotection and less warmth than the controls. Patients who perceived greater paternal favoritism, maternal overprotection and low paternal emotional warmth, showed higher levels of anxiety. Paternal affection and maternal attitudes of rejection, overprotection and favoritism were related with lower selfesteem. Regarding abnormal eating attitudes, body dissatisfaction inversely correlated with paternal emotional care and maternal favoritism. The EDI subscales: ineffectiveness, perfectionism and ascetism were associated with parental rejection. Maternal rejection also related with drive for thinness, interoceptive awareness and impulse regulation. Perceived emotional warmth was related with perfectionism. Bulimia subscale and BITE scores were inversely associated with paternal overprotection and affection, and scored significantly higher in paternal favoritism and rejection from both parents. Conclusions. Perceived parental bonding is different in the various subtypes of EDs. Patients diagnosed of Bulimia Nervosa or Eating Disorders Not Otherwise Specified perceived greater rejection, less affection and a greater overprotection than Anorexia Nervosa patients and controls