35
Bethesda, Maryland | September 19-21, 2013
good. Construct validity of the SATAQ-4 will be assessed via Pearson
product-moment correlations between the SATAQ-4 and measures of
body image, self-esteem, drive for muscularity, and eating pathology.
T56
Participation in Eating Disorder Research Studies is Associated with
Small Effect Sizes for Differences in Clinical Response
Colleen C. Schreyer, Janelle W. Coughlin, Graham W. Redgrave, Kivilcim
Gunay, Angela S. Guarda
Johns Hopkins School of Medicine, Baltimore, MD, USA
Ambivalence towards treatment is a core feature of anorexia nervosa and
may contribute to high attrition and low participation rates in treatment
studies, threatening the external validity of findings. We hypothesized that
individuals admitted to an integrated inpatient-partial hospital program
who refused participation in a longitudinal eating disorders research
study (non-participants) would show poorer response to treatment
than participants, but that effect sizes for group differences would be
low. Underweight inpatients (
N
= 427) were asked to participate in an
outcomes study at admission. Data collected on all patients included
admission and discharge BMI, inpatient (IP) and partial hospital (PH)
length of stay (LOS) and rates of weight gain, and achievement of target
weight. Participants (60%) had a longer LOS (IP,
ω
2
= .01; PH,
ω
2
=
.01)
and were more likely to attend PH (φ = .23) than non-participants.
Admission BMI and IP rates of weight gain did not differ; however
participants gained weight more rapidly in PH,
ω
2
= .02, and had a higher
BMI at program discharge (
ω
2
= .01). Study participation did not predict
achievement of target weight beyond the effects of discharge BMI, LOS,
and attending PH. At admission, groups did not differ. Participants showed
a better clinical response to treatment; however, with the exception of
PH attendance, effect sizes were small and below the recommended
minimum effect size for practical significance (RMPE) of .04 (Ferguson,
2009).
T57
The Role of Leptin, Cortisol, Estrogen, S100B and NSE on Gray
Matter Changes in Adolescent Anorexia Nervosa - A Longitudinal
Study
Jochen Seitz
1, 2
,
Katharina Bühren
1
,
Georg von Polier
1
,
Martin Walter
3
,
Beate Herpertz-Dahlmann
1
,
Kerstin Konrad
1
1
Department of Child and Adolescent Psychiatry, Psychotherapy
and Psychosomatics, Aachen, Germany,
2
Departement of Cognitive
Neuroscience, Maastricht, Netherlands,
3
Clinical Affective Neuroimaging
Laboratory, Magdeburg, Germany
Introduction:
Patients with Anorexia Nervosa (AN) loose about 10%
of their cortical gray matter during starvation. The extend to which this
volume loss is reversibel during weight recovery is unclear. Also, the
psychopathological mechanisms behind this dramatic change in brain
volume and its clinical implications are not well understood. Paralleling
these cortical changes during starvation serum levels of leptin and
estrogen levels are reduced and cortisol levels are increased. Results
on neuronal markers like S100B and neuron specific enolase (NSE) are
mixed. Their potential role in the brain volume changes has not been
analysed so far.
Methods:
We included 90 adolescent patients with AN
and 45 healthy controls (HC) in a longitudinal study. 67 patients could
be followed up at one year. 50 of the patients with AN and all HC also
received anatomical MRI to determine cortical thickness and subcortical
gray and white matter volume changes at up to three time points. Serum
blood levels of leptin, estrogen, morning cortisol, S100B and NSE
were examined at admission, discharge and one year after admission.
Also extensive psychopathological questionnaires and interviews were
administered at all three time points (EDI-2, SIAB-EX, BDI-II, SCAS,
SPAIK, SCL-90).
Results:
Data analysis is currently underway. Group
differences between patients with AN and HC, longitudinal interactions of
hormones with brain volume and potential predictors of clinical outcome
are going to be presented.
T58
Using a Text-Message Based Program to Promote Health Behavior in
Schoolchildren – Is it Effective?
Cátia Silva
1
,
Kathina Ali
1
,
Sónia Gonçalves
1
,
Eva Conceição
1
,
Ana Rita
Vaz
1
,
Daniel Fassnacht
2
,
Paulo PP Machado
1
1
University of Minho, Braga, Portugal,
2
James Cook University, Singapore,
Singapore
Several studies showed that technology-enhanced measures could be
a useful and innovating tool to promote health behaviors. In this study, a
Short Message Service (SMS) program was used to monitor three key
behaviors: fruit and vegetable consumption, physical activity and screen
time. Based on the daily input (SMS) of participants, supporting feedback
messages were automatically sent via the program. The aim of this
minimal intervention was to improve the indicated behaviors. Eight school
classes with a total of 139 children (age 8 to 10) were randomly assigned
to an intervention (8 weeks of monitoring and supportive feedback) (n=69),
and to a control group (n=70). Also, all the participants had their three key
behaviors assessed in different moments: pre-intervention (baseline), pos-
intervention and follow-up. A Latent Growth Curve Model (LGC) analyses
were developed to fit the longitudinal data. The purpose was to estimate
the differences between both groups in terms of their behaviors over
time, confirming or not the effectiveness of the program. According to the
analyses, this minimal intervention demonstrated to be a feasible program
to increase fruit and vegetable consumption. Nevertheless, there is a need
to further investigate such programs, 39.6% of the children of this sample
were overweight or obese. Hence, the adaption of this program and it
potentialities in other contexts such as outpatient treatment for childhood
obesity will be briefly referred.
T59
Treatment-Seeking Among Eating Disordered Adolecents and Young
Adults
Kendrin R Sonneville
1,2
,
Kamryn T Eddy
2,3
,
Nadia Micali
4
,
Ross D Crosby
5
,
Nicholas J Horton
6
,
Alison E Field
1,2
1
Division of Adolescent Medicine, Boston Children’s Hospital, Boston,
MA, USA,
2
Harvard Medical School, Boston, MA, USA,
3
Department of
Psychiatry, Massachusetts General Hospital, Boston, MA, USA,
4
UCL
Institute of Child Health, London, United Kingdom,
5
Neuropsychiatric
Research Institute, Fargo, ND, USA,
6
Department of Mathematics and
Statistics, Smith College, Northampton, MA, USA
Introduction
:
Previous research indicates that a minority of individuals
with a diagnosable eating disorder (ED) seek treatment. Studies among
youth and those which include individuals with binge eating disorder
(
BED) are scarce.
Methods
:
Prospective analysis of 3558 female in
the ongoing Growing Up Today Study (GUTS). Participants provided
information about ED symptoms via questionnaire every 12-24 months
from 1996-2013 and history of ED treatment in 2013. Underweight girls
who endorsed high shape/weight concerns were classified as having
probable anorexia nervosa (AN). Girls who engaged weekly in both binge
eating and purging were classified as having bulimia nervosa (BN). Girls
who reported binge eating weekly without purging were classified as
having BED.
Results
:
From 1996 to 2013, an estimated 1.6% of girls had
AN and 1.9% had BN. BED was the most common ED with 5.7% of girls
reporting symptoms consistent with BED, however, only 0.4% reported
ever having been diagnosed with BED. Girls with BN were most likely
(44%)
to have received ED treatment, followed by those with AN (30%).
Girls with BED were least likely (13%) to have received treatment for
their ED.
Conclusions
:
Only 22% of adolescent and young adult females
in GUTS, all children of registered nurses, who reported symptoms
consistent with a diagnosable ED received ED treatment. Efforts to
increase detection and referral for youth with eating disorder symptoms,
particularly those with BED, may be warranted.
T60
Methylation of the BDNF Gene Promoter in Women with Bulimia
Nervosa: Associations with Childhood Abuse, Suicidality and
Borderline Personality Disorder
Howard Steiger
1,2
,
Lea Thaler
1,2
,
Ridha Joober
2
,
Samantha Wilson
1
,
Patricia Groleau
1
,
Lise Gauvin
3
,
Mimi Israel
1,2
,
Amirthagowri
Ambalavanan
2
,
Rosherrie de Guzman
2
1
Eating Disorders Program. Douglas Institute, Montreal, QC, Canada,
2
Psychiatry Department, McGill University, Montreal, QC, Canada,
3
University of Montreal, Montreal, QC, Canada
Introduction
.
We examined the extent to which methylation of the Brain
Derived Neurotrophic Factor (BDNF) gene promoter corresponded to
having Bulimia Nervosa (BN) or, in women with BN, to having a history
of childhood abuse, suicidality, or Borderline Personality Disorder (BPD).
Methods
.
Using the Epityper platform, we measured methylation levels
in a targeted BDNF Exon-1 region using DNA obtained from lymphocytes
in 64 women with BN and 32 normal-eater women.
Results
.
Compared
to normal eaters, the women with BN showed hypermethylation in
specific CpGs of the selected promoter-region site. Such effects were
even more pronounced in bulimic women with comorbid BPD, or a
history of suicidality or childhood physical abuse. Hypermethylated CpG
sites corresponded in interpretable ways to sites associated in previous
research with BN-relevant traits and behaviors.
Discussion
.
Our findings
associate BN, especially when accompanied by BPD, suicidality, or
childhood abuse, with hypermethylation of certain BDNF Exon-1 sites.
The preceding points to epigenetic regulation of gene expression
corresponding, in women with BN, to exposure to developmental stress
and to heightened psychopathology.
POSTER SESSION 1 ABSTRACTS
