The present study compared the extent to which obese women with binge eating disorder (BED), obese women without BED, and controls discounted delayed and probabilistic money and directly consumable rewards: food, massage time, and preferred sedentary activity. Of special interest was whether the BED group differed from the other groups in terms of their discounting of all three types of directly consumable rewards or only in their discounting of food. Overall, the BED group tended to discount both delayed and probabilistic rewards of all types more steeply than the obese and control groups. Thus, rather than finding differences specific to particular types of rewards, we find that women with BED are generally more impatient when choices involve delayed rewards and more risk averse when they involve probabilistic rewards. These results suggest a temperamental difference associated with BED that cannot be accounted for by the concomitant obesity.
Loss of control over eating signals increased impairment independent of overeating in adolescents. Results support refining BED criteria for youth to reflect this distinction.
As publication of DSM-V draws near, research is needed to validate the
diagnostic scheme for binge eating disorder (BED). Shape and weight
overvaluation has stimulated considerable debate in this regard, given
associations with psychosocial impairment and poor treatment outcome in BED.
This study sought to further explore the convergent validity and diagnostic
specificity of shape and weight overvaluation in BED. A total of 160 women with
BED, and 108 women with non-eating disordered psychiatric disorders were
recruited from the community. Women with BED were classified as more or less
severe based on a global measure of eating-related psychopathology; subsequent
receiver operating characteristics analysis determined that a threshold of at
least “moderate” overvaluation best predicted membership into a
more severe group. BED participants with threshold overvaluation exhibited
poorer psychosocial functioning than those with subthreshold overvaluation, as
well as participants with other psychiatric disorders. Discriminant function
analysis revealed that threshold overvaluation predicted a diagnosis of BED
versus other psychiatric disorder with 67.7% accuracy. Results suggest that
shape and weight overvaluation is a useful diagnostic specifier in BED.
Continued research is warranted to examine its predictive validity in natural
course and treatment outcome studies.
Unlike traditional interventions, Internet interventions allow for objective tracking and examination of the usage of program components. Student Bodies (SB), an online eating disorder (ED) prevention program, significantly reduced ED attitudes/behaviors in college-aged women with high body image concerns, and reduced the development of EDs in some higher risk subgroups. The authors investigated how adherence measures were associated with ED attitudes and behaviors after treatment. Female SB participants (n = 209) completed the Eating Disorders Examination-Questionnaire (EDE-Q; C. G. Fairburn & S. J. Beglin, 1994) at baseline, posttreatment, and 1-year follow-up. Total weeks participation and frequency of utilizing the online Web pages/journals predicted pre- to posttreatment changes in EDE-Q Restraint but not in other ED symptoms. In participants with some compensatory behaviors, discussion board and booster session use were associated with increased weight/shape concerns during follow-up. In overweight participants, higher online Web page/journal use was related to decreased EDE-Q Eating Concern scores during follow-up. This is the first study to investigate the relationship between adherence to specific program components and outcome in a successful Internet-based intervention. Results can be used to inform future development and tailoring of prevention interventions to maximize effectiveness and facilitate dissemination.
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