Findings support the cognitive-behavioral premise that shape and weight overvaluation are at the core of AN psychopathology. Our BN and combined network findings provide a high degree of replication of previous findings. Clinically, findings highlight the importance of considering shape and weight overvaluation as a severity specifier and primary treatment target for people with EDs.

Objective: Anxiety is thought to influence the development and maintenance of eating disorders (EDs). However, little is known about how, specifically, anxiety influences ED symptoms and vice versa. Network analysis identifies how symptoms within and across disorders are interconnected. In a network, central nodes (i.e., symptoms) have the strongest relations to other nodes and are thought to maintain psychopathology. Bridge nodes are symptoms in one diagnostic cluster that are strongly connected to symptoms in another diagnostic cluster and are thought to explain comorbidity. We identified central and bridge nodes in a network of ED symptoms and trait anxiety features.Method: We estimated a regularized partial correlation network in patients with mixed EDs (N = 296). ED symptoms were assessed with the Eating Disorder Examination-Questionnaire. Trait anxiety was assessed with the Trait subscale of the State-Trait Anxiety Inventory. Items to include in the network were selected with a statistical algorithm to ensure that all nodes represented unique constructs. Central and bridge nodes were identified with empirical calculations.Results: Central ED nodes were dietary restraint, as well as overvaluation of and dissatisfaction with shape and weight. The central trait anxiety node was low feelings of satisfaction. The strongest ED bridge node was avoidance of social eating. The strongest trait anxiety bridge node was low self-confidence.

Implementation of evidence-based practices (EBPs) in intensive treatment settings poses a major challenge in the field of psychology. This is particularly true for eating disorder (ED) treatment, where multidisciplinary care is provided to a severe and complex patient population; almost no data exist concerning best practices in these settings. We summarize the research on EBP implementation science organized by existing frameworks and illustrate how these practices may be applied using a case example. We describe the recent successful implementation of EBPs in a community-based intensive ED treatment network, which recently adapted and implemented transdiagnostic, empirically supported treatment for emotional disorders across its system of residential and day-hospital programs. The research summary, implementation frameworks, and case example may inform future efforts to implement evidence-based practice in intensive treatment settings. K E Y W O R D Seating disorders, evidence-based implementation, evidence-based psychotherapy, residential treatment

No abstract

Individuals with anorexia nervosa, bulimia nervosa, and binge eating disorder experience elevated rates of suicidality compared to the general population. Suicide risk is higher when eating disorders occur with other psychological conditions. Additionally, genetic factors, emotion dysregulation, trauma, stressful life events, and lack of body regard may have roles in the development of both eating disorders and suicidality. Much of the risk for suicidality in eating disorders appears to be driven by comorbid psychopathology and genetic factors. However, the lack of longitudinal research makes it difficult to draw conclusions about the directionality or temporality of these relations; thus, novel methods are needed.

Objective Residential treatment for severe eating disorders (EDs) is associated with primarily positive outcomes. However, less is known about the moderators of treatment response. Comorbid post‐traumatic stress disorder (PTSD) diagnosis is associated with increased ED symptom severity. This study investigated whether PTSD moderated outcomes of transdiagnostic, residential ED treatment based upon the Unified Protocol. Method Female patients (N = 1055) in residential ED treatment completed a clinical interview to assess PTSD diagnosis and self‐reported ED, depression, and anxiety symptoms, anxiety sensitivity, experiential avoidance, and mindfulness. We tested whether PTSD moderated trajectories of symptom change from treatment admission to discharge and 6‐month follow‐up using multilevel models. Results PTSD moderated change in ED symptoms, depression severity, and experiential avoidance. Patients with PTSD showed steeper symptom improvements from admission to discharge. However, PTSD was associated with greater symptom recurrence after residential treatment. Conclusions Patients with comorbid PTSD demonstrated more improvement during residential treatment, but experienced steeper posttreatment symptom recurrence.

Objective Previous research shows that interoceptive deficits are associated with harmful behaviors such as nonsuicidal self‐injury (NSSI), eating disorder pathology, and suicide attempts. The present study replicates and extends this area of research by examining the association between interoceptive deficits and suicidality in a military sample. Method In Study 1, respondents to an online survey (N = 134) answered self‐report questionnaires related to interoceptive deficits. Study 2 consisted of a secondary data analysis of 3,764 military service members who had previously completed questionnaires on interoceptive indicators, NSSI, suicide thoughts and attempts, and other psychopathology. Results Study 1 demonstrated that our interoceptive deficits latent variable had adequate psychometric properties. In Study 2, multigroup confirmatory factor analysis showed that scores on the interoceptive deficits latent variable were highest among suicide attempters, lowest among those with no suicide history, and intermediary among participants who had thought about but not attempted suicide. The interoceptive deficits latent variable was more strongly related to NSSI and suicidality than were posttraumatic stress disorder symptoms, hopelessness, gender, and age. Conclusions These results confirm—and extend to a military sample—previous research showing that interoceptive deficits can provide important information about suicide risk.

Introduction: Grit is a personality trait that affords individuals the ability to push through challenging circumstances, suggesting tolerance of negative affect. In contrast, individuals with disordered eating are motivated to avoid negative affect. We speculated whether grit would buffer against disordered eating attitudes and behaviors, and conducted two studies to address this query. Method: Study 1 (N = 137) had participants from eating disorder treatment centers (n = 52) and adults from the community (n = 85). Disordered eating was assessed using the Eating Disorder Inventory. In Study 2, we tested whether emotion regulation strategy (i.e., cognitive reappraisal and expressive suppression) as an individual differences variable influenced the relation between grit and disordered eating within a community sample (N = 212). Disordered eating was assessed via the Eating Disorder Examination Questionnaire. In both studies, Grit-Consistency and Grit-Perseverance were measured using the Short Grit Scale. Results: Study 1 revealed that Grit–Consistency, not Grit–Perseverance, was associated with lower bulimia and body dissatisfaction scores. Further, moderation analysis indicated that this relation was consistent for both the clinical and community samples. Findings from Study 2 demonstrated that Grit–Consistency was inversely correlated with shape and weight concerns. Moderation regression analysis showed that elevated levels of expressive suppression attenuated the relation between Grit-Consistency and disordered eating. Discussion: Our work provides evidence that Grit-Consistency buffers against disordered eating. But elevated use of expressive suppression, a maladaptive emotion regulation strategy, eliminates the benefits of grit.