Network analysis of specific psychopathology and psychiatric symptoms in patients with anorexia nervosa

Abstract

In addition to ED-core symptoms, psychiatric comorbid symptoms should be the focus of specific treatments in patients with AN, independently from BMI.

Re‐conceptualization of anorexia nervosa psychopathology: A network analysis study in adolescents with short duration of the illness

“…The present findings are in line with previous studies which identified anxiety and depressive symptoms as well as interpersonal difficulties and ineffectiveness as the most central nodes in adult outpatients with mixed ED diagnoses (Solmi et al, ) and in an adult outpatient AN sample (Solmi et al, ). Another recent work also proved that negative affect symptoms, such as low self‐esteem, concentration difficulties, feeling overwhelmed and nervousness as well as shape and weight related concerns are central nodes in a network comprising a hospitalized adult ED population before and after treatment (Smith et al, ).…”

“…In agreement with our hypothesis, we detected some differences in our NA of adolescents with AN at the early stage of the illness compared to the findings of studies on adult AN patients (Solmi et al, ). In particular, asceticism and anxious physical symptoms seem to play a pivotal role in adolescents with AN.…”

“…More precise treatment is highly recommended at this stage of the disorder, as it may significantly modify the trajectory of the illness (Treasure et al, ). In line with the above cited study in adult patients with AN including the broadest spectrum of symptoms in the network (Solmi et al, ), we hypothesize that anxiety and depressive symptoms, in addition to ED core symptoms, play a pivotal role in the psychopathological network of children/adolescents with AN. In accordance with the only study assessing the comorbidity between PTSD at the first occurrence and AN (Vanzhula et al, ), we expect emotion dysregulation may represent a pathway connecting PTSD and AN core symptoms.…”

“…NA studies (DuBois, Rodgers, Franko, Eddy, & Thomas, ; Forbush, Siew, & Vitevitch, ) conducted on people affected by eating disorders (EDs) provided empirical support to the transdiagnostic perspective of EDs, which posits the overvaluation of shape and weight as the central core of ED psychopathology (Fairburn, Cooper, & Shafran, ). Recent studies also demonstrated the centrality of general psychiatric symptoms (anxiety and depressive symptoms, interpersonal problems, and ineffectiveness) together with ED core symptoms (drive to thinness and interoceptive awareness) in adult patients suffering from an ED (either AN, bulimia nervosa [BN], or binge‐eating disorder) or AN (Elliott, Jones, & Schmidt, ; Solmi et al, ; Solmi, Collantoni, Meneguzzo, Tenconi, & Favaro, ). Furthermore, network analyses were performed in order to assess comorbidity with anxious and depressive symptoms in people with BN (Levinson et al, ), comorbidity between EDs and social anxiety symptoms (Levinson et al, ), and comorbidity between post‐traumatic stress disorder and ED symptoms (Vanzhula, Calebs, Fewell, & Levinson, ).…”

“…According to the AN staging model (Treasure, Stein, & Maguire, ), this appears to be particularly important in AN given that interpersonal difficulties and comorbid psychiatric symptoms gradually worsen as the illness progresses (Cardi et al, ; Cardi, Tchanturia, & Treasure, ; Hudson, Hiripi, Pope Jr, & Kessler, ). Hence, an assessment of the relationships between general psychopathology and ED symptoms in adolescence may clarify whether general psychopathological symptoms are as central in young people with a short illness duration as in adults (Solmi et al, , ).…”