19
Bethesda, Maryland | September 19-21, 2013
in weight preoccupation was emotional eating.
Conclusions.
Future
research should further examine relationships between ovarian hormones,
psychological factors, and core eating disorder symptoms to more fully
understand the role of these etiologic influences across the full spectrum
of eating pathology.
11
ANATOMICAL CHARACTERISTICS OF THE CEREBRAL SURFACE IN
BULIMIA NERVOSA
Rachel Marsh
1,3
,
Mihaela Stefan
1
,
Ravi Bansal
2
,
Xuejun Hao
2
,
B. Timothy
Walsh
3
,
Bradley S. Peterson
3
1
The Division of Child and Adolescent Psychiatry in the Department of
Psychiatry, the New York State Psychiatric Institute and the College
of Physicians & Surgeons, Columbia University, New York, NY, USA,
2
The Center for Developmental Neuropsychiatry in the Department of
Psychiatry, the New York State Psychiatric Institute and the College of
Physicians & Surgeons, Columbia University, New York, NY, USA,
3
The
Eating Disorders Research Unit in the Department of Psychiatry, the New
York State Psychiatric Institute and the College of Physicians & Surgeons,
Columbia University, New York, NY, USA
Introduction:
Binge-eating episodes and other impulsive behaviors in
individuals with Bulimia Nervosa (BN) suggest deficits in self-regulation.
We examined the morphology of the cerebral surface across adolescent
and adult females who failed to activate frontostriatal circuits during fMRI
tasks of self-regulation (Marsh et al., 2009; 2011). We suspected that
relative to controls, BN participants would show reductions on the surface
of the frontal lobe.
Methods:
Anatomical MR images were acquired from
34
adolescent and adult females with BN and 34 healthy, age-matched
controls. We compared the groups in the morphological characteristics
of their cerebral surfaces while controlling for age.
Results:
Significant
reductions of local volumes on the brain surface were detected in
bilateral frontal areas in the BN compared to control participants. Greater
reductions in lateral inferior frontal cortices of the right hemisphere were
detected in those who engaged in the most objective bulimic episodes.
Reductions in medial and inferior frontal gyri of the left hemisphere
increased with increasing age and greater Stoop interference in the BN,
but not the control group.
Conclusion:
These findings suggest that local
volumes of inferior frontal regions are smaller in individuals with BN
compared to healthy individuals, and that these reductions may contribute
to functional deficits in self-regulation and to the persistence of these
deficits over development in BN.
12
WHAT DRIVES THE ASSOCIATION BETWEEN BODY-CONSCIOUS
PEER GROUPS AND DISORDERED EATING? DISENTANGLING
GENETIC AND ENVIRONMENTAL SELECTION FROM PURE
SOCIALIZATION EFFECTS
Shannon M. O’Connor, S. Alexandra Burt, Kelly L. Klump
Michigan State University, East Lansing, MI, USA
Objective:
Previous studies suggest strong associations between body-
conscious peer groups and disordered eating. This association has
been attributed to socialization effects (i.e., membership in peer groups
leads to disordered eating); however, selection effects (i.e., selecting
into peers group based on genetic or environmental predispositions
toward disordered eating) could contribute to or even account for these
associations. The current study was the first to use a co-twin control
design to disentangle genetic and shared environmental selection factors
from pure socialization effects.
Methods:
Participants included 430 female twins (ages 8-14) drawn
from the Michigan State University Twin Registry. Questionnaires were
used to assess disordered eating (e.g., body dissatisfaction, binge
eating, etc.) and peer group emphasis on body weight and shape.
Results
:
Replicating previous results, we found significant within-person
associations between membership in body-conscious peer groups and
disordered eating. However, co-twin control analyses indicated that
this association was due entirely to genetic and shared environmental
selection factors. Results remained unchanged when controlling for age,
BMI, and pubertal status.
Discussion:
These findings are the first to
suggest that associations between peer groups and disordered eating
may be due to
girls with genetic or environmental predispositions towards
disordered eating selecting into body-conscious peer groups.
13
LONGITUDINAL ASSOCIATIONS BETWEEN EMOTION REGULATION
DIFFICULTIES AND ANOREXIA NERVOSA SYMPTOMS: A CROSS-
LAGGED ANALYSIS
Sarah E. Racine
1
,
Jennifer E. Wildes
1,2
1
Western Psychiatric Institute and Clinic, University of Pittsburgh Medical
Center, Pittsburgh, PA, USA,
2
Department of Psychiatry, University of
Pittsburgh School of Medicine, Pittsburgh, PA, USA
Introduction
:
Cross-sectional studies have shown that emotion regulation
difficulties are associated with anorexia nervosa (AN) and its component
symptoms. However, no research has used longitudinal methodology to
examine whether emotion regulation difficulties predict the expression
and severity of AN symptoms, or vice versa. The current study used a
longitudinal design to evaluate bidirectional associations between emotion
regulation difficulties and AN symptoms.
Method
:
Participants were 194
individuals with AN recruited for a larger study. Assessments including
the Difficulties in Emotion Regulation Scale and the Eating Disorders
Examination were completed at discharge from intensive treatment
and at 3-, 6-, and 12-month follow-ups. Cross-lagged panel analyses
were used to test longitudinal relationships between emotion regulation
difficulties and AN symptoms.
Results
:
Overall emotion dysregulation
predicted an increase in eating disorder cognitions and likelihood of
recurrent purging. Conversely, eating disorder cognitions predicted more
problems with emotional awareness, and recurrent binge eating predicted
poorer impulse control. Finally, bidirectional relationships existed
between impulse control problems and recurrent purging.
Conclusions
:
Emotion regulation deficits appear to be both vulnerability factors for and
consequences of AN symptoms. Findings underscore the importance of
addressing emotion regulation difficulties in treatments for AN.
14
TESTING THE INSULA HYPOTHESIS OF ANOREXIA NERVOSA:
STUDIES IN FMRI
Bryan Lask
1,2,5
,
Ian Frampton
1,3,5
,
Kenneth Nunn
4
1
Gt. Ormond St. Hospital for Children NHS Trust, London, United
Kingdom,
2
Care UK, London, United Kingdom,
3
Exeter University, Exeter,
United Kingdom,
4
Hospital for Sick Children, Sydney, Australia,
5
Oslo
University Hospital, Oslo, Norway
Purpose
of Study Recent neuroscience hypotheses (Nunn et al,
2008; 2011)
predict that young people with anorexia nervosa have
an underlying abnormality of function in neural networks involving
the insula cortex. We have therefore designed a study to test this
hypothesis using functional neuroimaging techniques.
Methods
:
Participants completed computerized tasks of mental rotation,
inhibition, body image and switching, designed to load on insula
networks, while their brain response was analysed using functional
magnetic resonance imaging (fMRI). Statistical parametric mapping
was used to explore group differences in brain activation patterns
between young people in the acute stage of anorexia nervosa (n = 21)
compared with age matched control participants.
Results
:
Significant
group differences were observed on all tasks. Controlling for the effect
of anxiety and depression, the tasks activated a distributed network
centred on the Insula Cortex.
Conclustion
:
These results cannot
refute the hypothesis that dysregulation of insula networks are central
to the psychopathology of anorexia nervosa. Further analyses of the
data and the potential clinical implications are explored.
PARALLEL PAPER SESSION
Friday, 8:30 - 10:00 AM
Lalique
Developmental-Child/Adolescent
15
METABOLIC CHARACTERISTICS IN ADOLESCENT GIRLS WITH
LOSS OF CONTROL EATING: DOES EPISODE SIZE MATTER?
Rachel Miller
1,2
,
Marian Tanofsky-Kraff
1,2
,
Lauren B. Shomaker
1,2
,
Louise
Hanallah
1,2
,
Sheila M. Brady
2
,
Tania Condarco
2
,
Jack A. Yanovski
2
1
Department of Medical and Clinical Psychology, Uniformed Services
University of the Health Sciences, Bethesda, MD, USA,
2
Section on
Growth and Obesity, Program in Developmental Endocrinology and
Genetics, Eunice Kennedy Shriver National Institute of Child Health and
Human Development (NICHD) National Institutes of Health (NIH), DHHS,
Bethesda, MD, USA
Preliminary data in adults suggest that, independent of its effect on
adiposity, binge eating is associated with greater prevalence metabolic
syndrome components. There are limited data in youth, and little is known
of the role of binge episode size in these relationships. We therefore
examined the relationship between loss of control (LOC) eating and
metabolic characteristics in a sample of 127 adolescent girls (age M±SD
14.6
±1.6 y) deemed at high-risk for excess weight gain due to a BMI
(
kg/m
2
)
in the 75
th
-97
th
%
ile prior to participating in an obesity prevention
program. The EDE was used to determine presence objective binge
episodes (OBE), subjective binge episodes (SBE), or either/both (LOC) in
the past month. Adiposity was measured by DEXA. Metabolic syndrome
components (blood pressure, lipids, and waist circumference) were the
primary outcomes. 88% of girls reported LOC, and among those, 71%
reported SBE only and 29% reported OBE. Girls with LOC had higher
diastolic blood pressure (
p
=.016) and lower HDL cholesterol (
p
=.001)
compared to those without LOC, in analyses adjusted for fat mass,
height, age and race. Among those with LOC, girls with OBE had higher
total cholesterol (
p
=.02) compared to those with SBE. We conclude that
adolescent girls reporting LOC, especially those with objectively large
LOC episodes, may have greater metabolic dysregulation than girls
without LOC. Prospective data are needed to determine the impact of
episode size on physiological outcomes.
ORAL ABSTRACTS
