Obsessive–compulsive symptoms in eating disorders: A network investigation

Abstract

Objective Eating disorders (EDs) are complex, heterogeneous, and severe psychiatric syndromes. They are highly comorbid with obsessive–compulsive disorder (OCD) which exacerbates the course of illness and impedes treatment. However, the direct functional relations between EDs and OCD symptoms remain largely unexplored. Hence, using network analysis, we investigated the relationship between ED and OCD at the level of symptoms in a heterogeneous clinical sample. Method We used cross sectional data of 303 treatment‐seeking patients with clinically relevant ED and OCD pathology. We constructed a regularized partial correlation network that featured both ED and OCD symptoms as nodes. To determine each symptom's influence, we calculated expected influence (EI) as an index of symptom centrality (i.e., “importance”). Bridge symptoms (i.e., symptoms from one syndromic cluster that have strong connections to symptoms of another syndromic cluster) were identified by computing bridge expected influence metrics. Results Fear of weight gain and dietary restraint were especially important among the ED symptoms. Interference due to obsessions was the key feature of OCD. ED and OCD clustered distinctly with few potential bridges between clusters. Discussion This study underscores the importance of cognitive symptoms for both ED and OCD although direct functional links between the two clusters are missing. Potentially, a network incorporating nodes capturing features of personality may account for diagnostic comorbidity better than specific symptoms of EDs or features of OCD do.

Psychopathological Networks in Cognitive-Behavioral Treatments for Binge-Eating Disorder

“…At pretreatment, 3 distinct network communities of eating disorder psychopathology, general psychopathology (also including dispositional sensitivity to punishment and reward), and restraint and BMI were identified, which is consistent with cross-sectional network research on BED, mixed eating disorders, and obesity [15][16][17]38]. In line with most literature on these disorders [15][16][17][39][40][41][42], eating disorder-related impairment, low self-esteem, and shape concern were among the most central indicators, whereas BMI and binge eating were the least central. The relatively low centrality of punishment and reward sensitivity is consistent with previous evidence on mixed eating disorders [16], likely associated with their general, non-eating-disorder-related formulation.…”

Eating disorder fear networks: Identification of central eating disorder fears

“…This research also builds on findings showing that NA-identified central symptoms predict clinical outcomes, such as BMI and depression (Brown et al, 2020;Meier et al, 2020;Olatunji et al, 2018 (Brown et al, 2020;Olatunji et al, 2018), these findings suggest that ED-related fears may contribute to higher excessive-exercise across time. We did not how-…”

Orthorexia Nervosa: over concern or obsession about healthy food?

“…However, food obsessions prevalently are not ego-dystonic in individuals with ON [1,33], and rituals could not intend to reduce anxiety symptoms related to thought, as it happens in OCD [40,41]. Indeed, the repetitiveness and permanence of food-related thinking might suggest an excessive concern about the food healthiness and its preparation, rather than an obsession followed by a compulsion to neutralize it.…”