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Bethesda, Maryland | September 19-21, 2013
F12
Subtyping Early Rapid Response in a Binge-Eating Trial
Eunice Y Chen
1
,
Peggy Chau
2
,
Kalina Eneva
3
,
Taylor Dryman
4
,
Dawn
Eichen
5
,
Joy Harrington
6
1
Psychology, Temple University, Philadelphia, PA, USA,
2
The University of
Chicago, Chicago, IL, USA,
3
Psychology, Temple University, Philadelphia,
IL, USA,
4
Psychology, Temple University, Philadelphia, PA, USA,
5
Psychology, Temple University, Philadelphia, PA, USA,
6
Psychology,
Temple University, Philadelphia, PA, USA
Early non-response to treatment is associated with worse outcome at
the end of treatment across psychotherapies and disorders.
Purpose
:
to examine if early rapid non-response to treatment can be predicted by
subtyping prior to treatment in a binge-eating trial.
Methods
:
Using cluster
analysis, 111 women with binge-eating disorder or bulimia nervosa were
subtyped prior to guided self-help Cognitive-Behavior Therapy (GSH)
and these subtypes were used to predict early rapid non-response at the
4
th
session of GSH.
Results:
In this sample, cluster analysis revealed
a “dietary-depressive” subtype (37%) and a “dietary” subtype (62%).
The “dietary-depressive” subtype compared to the “dietary” subtype was
significantly more likely to report initial: 1) greater frequency of objective
binge-eating, 2) greater eating and shape concerns, 3) greater number
of axis I disorders and 4) poorer global functioning. Although subtype did
not predict early rapid non-response, the “dietary-depressive” subtype had
significantly worse general eating disorder psychopathology at the 4th
session of GSH (p<.05).
Conclusions:
Although subtyping is associated
with greater eating disorder and global impairment, it did not predict early
rapid non-response in GSH in this trial of binge-eating women.
F13
Peer-Delivered Dissonance-Based Eating Disorder Prevention in High
School Girls: Results From an Initial Effectiveness Trial
Anna C Ciao
1,2
,
Janet D Latner
2
,
Krista E Brown
2
,
Daria S Ebneter
2
,
Carolyn B Becker
3
1
The University of Chicago Department of Psychiatry and Behavioral
Neuroscience, Chicago, IL, USA,
2
University of Hawaii at Manoa
Department of Psychology, Honolulu, HI, USA,
3
Trinity University
Department of Psychology, San Antonio, TX, USA
The aim of this study was to evaluate a dissonance-based eating disorder
prevention program delivered using high school peer leaders. Following
a pilot feasibility study, a quasi-experimental design evaluated program
outcomes. Peer leaders (
N=
10)
received 12 hours of training to deliver
the 2-session program. Participants were girls in freshman health classes
(
N=
50).
Half of the classes served as a waitlist control, receiving the
intervention after a 2-week assessment-only waitlist period. All participants
were assessed pre- and post-intervention and at a 3-month follow-up
with multiple measures of four outcomes: thin-ideal internalization, body
dissatisfaction, eating pathology, and dietary restraint. Condition-by-
time interactions from repeated measures ANOVA analyses indicated
significantly greater pre-post reductions in a majority of outcomes for
those in peer-led groups compared to waitlist controls. Groups were
combined to assess program effects over time with one-way repeated
measures ANOVAs. Results indicated significant pre-post reductions in
a majority of outcomes that were sustained through 3-month follow-up,
except for thin-ideal internalization, which returned to baseline levels.
Some discrepancies were found in measures assessing similar outcomes.
Results of this study provide tentative support for using high school peer
leaders to implement dissonance-based eating disorder prevention.
Further research is needed to replicate results in larger controlled trials.
F14
Neuroimaging of Stress Effects and Limbic System Response to
Cues in Obesity
Brittany Collins
1
,
James MacKillop
1
,
Sarah Fischer
2
1
University of Georgia, Athens, GA, USA,
2
George Mason University,
Fairfax, VA, USA
Obese (OB) individuals may exhibit increased BOLD activation in limbic
system regions after exposure to food cues compared to neutral cues,
and compared to healthy weight (HW) controls. Acute stress, however,
may cause decreased activation in limbic regions. Thus, limbic response
to food cues under acute stress, and its’ with craving, is unknown. We
examined responses to palatable food cues and self-report craving for
food in 10 OB and 10 HW individuals both prior to and following an acute
stress induction utilizing functional Magnetic Resonance Imaging (fMRI). In
a priori hypothesized regions of interest (ROIs), HW individuals exhibited
greater activation in the anterior cingulate cortex (ACC) and the nucleus
accumbens (NAc) than OB participants after exposure to food cues
compared to neutral cues. A similar pattern was observed in post stress
food cue to pre stress food cue comparisons; HW individuals exhibited
greater activation in the ACC and NAc compared to OB participants.
However, all participants exhibited decreased activation in these regions,
and the insula, to food cues following the stress induction. Increases in
activation were observed in the orbitofrontal cortex when contrasting post
stress food cues to pre stress food cues, as well as increases in self-report
craving. Exploratory post hoc whole brain analyses indicated that several
regions other than a priori identified ROIs exhibited changes in activation
from pre stress to post stress exposure to food cues.
F15
Exercise Dependence and Health-Related Quality of Life in Eating
Disorders
Brian Cook
1
,
Scott Engel
1,2
,
Ross Crosby
1,2
,
Heather Hausenblas
3
,
Stephen Wonderlich
1,2
,
James Mitchell
1,2
1
Neuropsychiatric Research Institute, Fargo, ND, USA,
2
University of
North Dakota School of Medicine and Health Sciences, Fargo, ND, USA,
3
Jacksonville University, Jacksonville, FL, USA
INTRODUCTION
.
Recent research suggests pathological motivations
for exercise (e.g., exercise dependence), but not exercise behavior, may
explain the association between exercise and eating disorders (ED).
However, few studies have examined the impact of exercise dependence
on ED-specific quality of life (QOL). The purpose of our study was to
examine the effect of exercise dependence on ED-specific QOL, level of
ED symptoms on QOL, and the interaction of exercise dependence and
ED symptoms on QOL. We hypothesized that QOL would be inversely
associated with exercise dependence.
METHOD
.
Surveys assessing ED
symptoms, ED-specific QOL, and exercise dependence were collected
from female students (N = 387). Regression analyses were conducted
to examine the relationship among these variables.
RESULTS
.
The
overall model examining the impact of ED symptoms and exercise
dependence on QOL was significant (
p
<.01) and explained 16.1% of the
variance in QOL. ED symptoms (β=.40,
p
=.01), as well as higher exercise
dependence scores (β=.23,
p
=.01), both predicted impaired QOL. The
interaction among ED symptoms and exercise dependence was significant
(
β=.187,
p
=.040) suggesting that the combined effects of ED symptoms
and exercise dependence significantly impair QOL.
CONCLUSIONS
Individuals with ED symptoms and higher exercise dependence scores
may experience more QOL detriments. Our results suggest that
pathological motivations for exercise may exacerbate the detrimental
impact of ED on QOL.
F16
“
From Benchside To Bedside”: Prenatal Testosterone Exposure
Decreases Severity of Anorexic-Like Symptoms in Adolescent
Female Mice and Girls
Kristen M. Culbert
1
,
Stephanie J. Klenotich
1
,
Stephanie C. Dulawa
1, 2
,
Daniel Le Grange
1
1
Department of Psychiatry & Behavioral Neuroscience, University of
Chicago, Chicago, IL, USA,
2
Committee on Neurobiology, University of
Chicago, Chicago, IL, USA
Elevated prenatal testosterone exposure has been shown to be protective
against the development of eating pathology; however, no prior study has
examined if prenatal testosterone is linked to decreased symptom severity
in patients ill with an eating disorder. This study used a translational
approach to examine whether elevated prenatal testosterone predicts
decreased severity of anorexic-like symptoms in adolescent female BALB/
cJ mice (n = 10) and girls with anorexia nervosa (current n = 10). Anorexic-
like symptoms were assessed using the activity-based anorexia paradigm
in mice (i.e., food-restricted mice develop hypophagia and increased
physical activity resulting in severe weight-loss) and Eating Disorder
Examination (EDE) scores (e.g., dietary restraint, body weight and shape
concerns) in girls. Prenatal testosterone exposure was measured using
biomarkers: anogenital distance in mice and digit ratios [index (2D)/
ring (4D) finger] in girls. As expected, female mice exposed to elevated
prenatal testosterone (i.e., longer anogenital distance) took more days
to reach a life-threatening body weight from activity-based anorexia (rho
= .62), and girls exposed to elevated prenatal testosterone (i.e., lower
2
D:4D) scored lower on all EDE scales (r’s = .27-.70). These preliminary
data suggest that prenatal testosterone may exert protective effects that
reduce eating disorder symptom severity, and thus, contribute to individual
differences in eating pathology during the ill-state.
F17
The Influence of Emotions on Decision Making in Women with
Restrictive and Binge-Purge Type Anorexia Nervosa
Unna N. Danner
1,2
,
Lot Sternheim
1,2,3
,
Jojanneke Bijsterbosch
1,2
,
Alexandra
E. Dingemans
4
,
Annemarie A. van Elburg
1,2,5
1
Altrecht Eating Disorders Rintveld, Zeist, Netherlands,
2
Utrecht Research
Group Eating Disorders, Utrecht, Netherlands,
3
Department of Clinical and
Health Psychology, Utrecht University, Utrecht, Netherlands,
4
Center for
Eating Disorders Ursula, Leidschendam, Netherlands,
5
University Medical
Center Utrecht, Utrecht, Netherlands
Introduction:
Research has demonstrated decision making difficulties
in anorexia nervosa (AN) patients. A possible factor underlying these
difficulties are the affective disturbances seen in AN patients (e.g.
maladaptive emotion regulation). Impulsiveness is another factor
underlying decision making ability that differs between AN restrictive
(
ANr) and binge-purge (ANbp) patients. ANbp patients seem to show
more impulsive behaviours, particularly in response to negative affect.
The aim was to examine the influence of negative emotions on decision
POSTER SESSION 2 ABSTRACTS
