No abstract

Purging disorder is a clinically significant disorder of eating that appears to be distinct from bulimia nervosa on subjective and physiological responses to a test meal. Findings support further consideration of purging disorder for inclusion in the classification of eating disorders. Future studies on the psychobiology of purging disorder are needed to understand the propensity to purge in the absence of binge eating.

The role of anxiety has been emphasized in etiological/maintenance models of anorexia nervosa. This study identified daily patterns of anxiety in anorexia nervosa and examined the likelihood of the occurrence of eating disorder behaviors in each trajectory, the daily temporal distribution of eating disorder behaviors in each trajectory, and the extent to which the tendency to exhibit particular anxiety trajectories was associated with baseline diagnostic and trait-level personality variables. Women with full or subthreshold anorexia nervosa (N = 118) completed a two-week ecological momentary assessment (EMA) protocol during which they reported on a variety of behavioral and affective variables, including anxiety and eating disorder behaviors. Using latent growth mixture modeling to classify EMA days (N = 1526) based on anxiety ratings, seven distinct daily anxiety trajectories were identified. Overall differences between trajectories were found for rates of binge eating, self-induced vomiting, body checking, skipping meals, and dietary restriction. Further, distinct daily temporal distributions of eating disorder behaviors were found across the trajectories, with peaks in the probability of behaviors frequently coinciding with high levels of anxiety. Finally, traits of personality pathology (affective lability, self-harm, social avoidance, and oppositionality) and the presence of a co-occurring mood disorder were both found to be associated with the tendency to experience particular daily anxiety trajectories (e.g., Stable High anxiety). Findings support the presence of within-person variability in daily anxiety patterns in anorexia nervosa and also provide evidence for an association between these anxiety patterns and eating disorder behaviors.

This study examined the unique associations between eating disorder symptoms and two emotion-related constructs (affective lability and anxiousness) assessed via distinct methodologies in anorexia nervosa (AN). Women (N=116) with full or subthreshold AN completed baseline emotion and eating disorder assessments, followed by two weeks of ecological momentary assessment (EMA). Hierarchical regressions were used to examine unique contributions of baseline and EMA measures of affective lability and anxiousness in accounting for variance in baseline eating disorder symptoms and EMA dietary restriction, controlling for age, body mass index, depression, and AN diagnostic subtype. Only EMA affective lability was uniquely associated with baseline eating disorder symptoms and EMA dietary restriction. Anxiousness was uniquely associated with baseline eating disorder symptoms regardless of assessment method; neither of the anxiousness measures was uniquely associated with EMA dietary restriction. Affective lability and anxiousness account for variance in global eating disorder symptomatology; AN treatments targeting these emotion-related constructs may prove useful.

No abstract

No abstract

Background College students continue to report nonmedical prescription stimulant use to enhance alertness and concentration. Despite increasing prevalence of this behavior, techniques for preventing or treating it are lacking. An intervention that focuses on challenging positive consequence-oriented beliefs about prescription stimulants may be efficacious in preventing use. Methods The current study examined the efficacy of a randomized controlled expectancy challenge intervention to prevent nonmedical prescription stimulant use among 96 at-risk, stimulant-naïve college students (i.e., low grade point average, Greek involvement, binge drinking, cannabis use). Forty-seven participants completed a brief expectancy challenge intervention aimed at modifying positive expectancies for prescription stimulants, to consequently deter initiation of use. The remaining participants received no intervention. Results The expectancy challenge successfully modified expectancies related to prescription stimulant effects. Nevertheless, this intervention group and a control group showed comparable rates of nonmedical prescription use at six-month follow-up. However, negative expectancies were significant predictors of reduced odds of future use. Conclusions A challenge session appears to modify stimulant-related expectancies, which are related to nonmedical prescription stimulant use. Nevertheless, a more potent challenge or booster sessions might be essential for longer-term changes.

Objective The purpose of this study was to compare the type and frequency of restrictive eating behaviors across the two subtypes of anorexia nervosa (AN; restricting [ANr] and binge eating/purging [ANbp]) using ecological momentary assessment (EMA) and to determine whether subtype differences in restrictive eating behaviors were attributable to severity of the disorder or the frequency of binge eating. Method Participants (N = 118) were women at least 18 years of age with full (n = 59) or sub-threshold (n = 59) AN who participated in a two week (EMA) protocol. Results General estimating equations revealed that individuals with ANbp generally reported more frequent restrictive eating behaviors than individuals with ANr. These differences were mostly accounted for by greater severity of eating psychopathology, indicating that the presence and frequency of restrictive eating behaviors in AN may be non-weight-based markers of severity. Binge eating frequency did not account for these findings. Discussion The present findings are especially interesting in light of the weight-based severity rating in the DSM-5.