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Bethesda, Maryland | September 19-21, 2013
F34
Pretreatment Attachment Anxiety Predicts Change in Depressive
Symptoms in Women Who Complete Day Hospital Treatment for
Anorexia and Bulimia Nervosa
Leah Keating
1
,
Giorgio A. Tasca
2, 3
,
Hany Bissada
2, 3
1
York University, Toronto, ON, Canada,
2
University of Ottawa, Ottawa, ON,
Canada,
3
The Ottawa Hospital, Ottawa, ON, Canada
Individuals with eating disorders are prone to depressive symptoms.
Depressive symptoms predict poorer treatment outcomes in women with
eating disorders. Treatment outcomes are worse for those with anorexia
nervosa and for those who are higher in attachment anxiety. The current
study examines whether depressive symptoms improve in women who
attend day treatment for anorexia and bulimia nervosa, and whether eating
disorder diagnosis and pretreatment attachment anxiety predict changes
in depressive symptoms. Participants were 141 women with anorexia
nervosa restricting type (
n
= 24), anorexia nervosa binge-eating/ purging
type (
n
= 30), and bulimia nervosa (
n
= 87) who attended an eating
disorders day hospital program. They completed a pretreatment self-report
measure of attachment insecurity, and a pretreatment and posttreatment
self-report measure of depressive symptoms. Participants experienced
significant reductions in depressive symptoms during treatment. Eating
disorder diagnosis was not related to these improvements. However,
participants lower in attachment anxiety experienced significantly greater
improvements in depressive symptoms than those who were higher in
attachment anxiety. These results suggest that depressive symptoms
can improve during day hospital treatment for women with anorexia and
bulimia nervosa. Clinicians may tailor eating disorders treatments to
patients’ attachment patterns to improve depressive symptoms.
F35
DSM-5 Binge Eating Disorder and Its Component Behaviors in the
General Population
Anna Keski-Rahkonen, Linda Mustelin, Anu Raevuori, Aila Rissanen,
Jaakko Kaprio
University of Helsinki, Helsinki, Finland
Background:
Few studies have systematically assessed the prevalence
of binge eating and its component behaviors in the general population.
Method:
To assess the lifetime prevalence of binge eating, young adults
(
N=5247) from the 1975-79 birth cohorts of Finnish twins were assessed
by questionnaires, including questions about eating and compensatory
behaviors (vomiting, laxatives, diuretics or enemas). A composite
“
probable BED” was formed using three items (frequent binge eating/
overeating + not being able to stop eating + absence of compensatory
behaviors). From women, diagnostic information was also collected using
the SCID for DSM-IV (modified for DSM 5)
Results:
Based on interviews,
the lifetime prevalence of DSM-5 BED was 1.0% and DSM-IV BED 0.55%
among women and “probable BED” 1.3% among women and 0.9% among
men. Among participants who had never engaged in compensatory
behaviors, 12.2% of women and 16.8% of men reported often stuffing
themselves with food; 16.7% of women and 2.1% of men felt extremely
guilty after overeating; 2.1% of women and 1.1% of men felt they could
not stop eating; 1.1% of women and 0.5% of men ate in secret, and 2.0%
of women and 1.2% of men ate little while others were present but a lot
when alone.
Conclusion
:
The operationalization of “binge eating” has
a substantial impact on prevalence estimates. In both sexes, overeating
is common. Not being able to stop eating, eating alone or in secret are
markers of potentially problematic behaviors.
F36
Addicted to Skinny: Activity-Based Anorexia Induces Changes in
Markers of Neuroplasticity in the Mesolimbic Reward Pathway
Stephanie J Klenotich, Emily V Ho, Daniel Le Grange, Stephanie C
Dulawa
University of Chicago, Chicago, IL, USA
The activity-based anorexia (ABA) phenomenon provides a rodent
model for aspects of AN. In ABA, rodents housed with a running wheel
and subjected to daily food restriction exhibit severe drops in body
weight, hypophagia, and hyperactivity that can result in death. Four
groups of female Balb/cJ mice (9weeks baseline) were exposed to the
ABA paradigm: group 1- ad libitum fed mice, group 2- food restricted
mice, group 3- mice housed with wheels, and group 4- mice housed
with wheels and food restricted (ABA). Relative quantitative PCR was
used evaluate gene expression of brain-derived neurotrophic factor
(
BDNF) and neural cell adhesion molecule 1 (NCAM1) within the nucleus
accumbens (NAc), medial prefrontal cortex (mPFC), hippocampus (HPC)
and ventral tegmental area (VTA) in mice exposed to the ABA paradigm.
Mice exposed to food restriction had reductions in BDNF expression in
the mPFC, while expression was increased in the HPC and VTA. Food
restriction also reduced and increased NCAM1 expression in the VTA and
HPC, respectively. Furthermore, mice housed with wheels had significantly
increased BDNF levels in VTA. Changes in BDNF and NCAM1 expression
in the mesolimbic reward pathway may play a role the maladaptive
relationship between increased wheel running and reduced food intake to
induce ABA behavior. Future work will employ viral-vector technology to
directly manipulate BDNF and NCAM1 expression in these regions to alter
susceptibility to ABA.
F37
Altered Cortical Response to Negative Emotional Stimuli in Anorexia
Nervosa: A Pilot fMRI Study
Jason M Lavender
1
,
Kathryn R Cullen
2
,
Carol B. Peterson
2
,
Kelvin O. Lim
2
,
Stephen A. Wonderlich
1,3
,
Leah M. Jappe
2
,
Scott J. Crow
2
1
Neuropsychiatric Research Institute, Fargo, ND, USA,
2
University of
Minnesota, Minneapolis, MN, USA,
3
University of North Dakota School of
Medicine and Health Sciences, Fargo, ND, USA
Introduction
:
Evidence suggests that emotion processing, cognitive
control, and reward functions are altered in anorexia nervosa (AN). This
study examined brain activation in response to negative affective stimuli
(
fear and angry faces) and associations with measures of cognitive control
and reward in restricting AN (ANr) and healthy controls (HC).
Methods
: 12
young women (7 ANr, 5 HC) completed a task involving matching either
negative emotional faces or neutral shapes while undergoing fMRI. Whole
brain group differences were examined and correlations were calculated
between the clinical measures and brain activation in the group-difference
clusters and regions of interest in the amygdala.
Results
:
ANr exhibited
lower activation in areas relevant to emotion processing and cognitive
control compared to HC: anterior cingulate cortex (ACC), paracingulate,
precentral gyrus, and postcentral gyrus. Attentional impulsivity was
negatively correlated with activation in these clusters (ps<.05). Activation
in the ACC, postcentral gyrus, and paracingulate was negatively
correlated with behavioral inhibition (ps<.05). Left amygdala activation was
negatively correlated with reward responsiveness (p<.05) and fun seeking
(
p<.05).
Conclusions
:
Lower activity in frontal regions when processing
negative emotional stimuli may be a marker for altered affect regulation
and cognitive control in AN. Future research is needed to elaborate the
neurobiological underpinnings of these processes in AN.
F38
Pregnancy, Obstetric and Neonatal Health Outcomes in Eating
Disorders
Milla S Linna
1
,
Anu Raevuori
1,2
,
Jari Haukka
1,3
,
Jaana Suvisaari
3,5
,
Jaana
Suokas
3,4
,
Mika Gissler
6,7
1
Hjelt Institute, Department of Public Health, University of Helsinki,
Helsinki, Finland,
2
Department of Adolescent Psychiatry, Helsinki
University Central Hospital, Helsinki, Finland,
3
Department of Mental
Health and Substance Abuse Services, National Institute for Health and
Welfare, Helsinki, Finland,
4
Department of Psychiatry, Helsinki University
Central Hospital, Helsinki, Finland,
5
Department of Social Psychiatry,
Tampere School of Public Health, Tampere, Finland,
6
National Institute
for Health and Welfare, Helsinki, Finland,
7
Nordic School of Public Health,
Gothenburg, Sweden
Introduction:
To study pregnancy, obstetric, and neonatal health
outcomes in women with lifetime eating disorders (ED).
Methods:
Female (
n
=2 257) patients treated at Eating Disorder Clinic of
Helsinki University Central Hospital during 1995-2010 were compared
with unexposed women retrieved from the population (
n
=9028). Register-
based information on pregnancy, obstetric, and neonatal outcomes were
acquired for all singleton births during the follow up time among women
with broad anorexia nervosa (AN
n
=302 births), broad bulimia nervosa
(
BN
n
=724), binge eating disorder (BED
n
=52), and unexposed women
(
n
=6319).
Results:
Women with AN and BN gave birth to babies with
lower birthweight compared to unexposed women, the opposite was
observed in BED. Maternal AN was positively associated with anemia,
intra-uterine fetal death, slow fetal growth, premature contractions,
short duration of the first stage of labor, very premature birth, small for
gestational age and low birth weight infants, as well as perinatal death.
Increased odds of premature contractions, resuscitation of the neonate,
and very low Apgar score at 1 min were observed in mothers with BN.
BED was positively associated with hypertension, long duration of the first
and second stage of labor, and birth of large for gestational age infants.
Obstetric complications occurred in similar proportions in women with EDs
and unexposed women.
Conclusions:
EDs are related to severe adverse
pregnancy and neonatal health outcomes.
F39
Diagnostic Subtypes of Feeding Disorders in Infancy: An Empirical
Contribution on Mother-Child Feeding Interactions, Child and Mother
Psychopathological Risk Factors
Loredana Lucarelli
University of Cagliari, Cagliari, Italy
Introduction
:
DC:0-3, the manual of Mental Health and Developmental
Disorders of Infancy and Early Childhood, in the last revision (2005),
included six feeding disorders. The DSM-5 Avoidant/Restrictive Food
Intake Disorder (ARFID) recognized three of the six FD in Zero To Three:
Infantile Anorexia is under “lack of interest”, Sensory Food Aversions is
under “sensory avoidance”, feeding disorder associated with insults to
the gastrointestinal tract is under “fear-based avoidance”. The recognition
of FD subtypes is useful to explore factors involved in etiology, clinical
POSTER SESSION 2 ABSTRACTS
