Transdiagnostic vulnerability factors in eating disorders: A network analysis

Abstract

Objective: Eating disorder (ED) symptoms and transdiagnostic vulnerability characteristics play a crucial role in the aetiology and maintenance of EDs. Over the last decade, researchers have started to model complex interrelations between symptoms using network models, but the literature is limited in that it has focused solely on symptoms and investigated-specific disorders while ignoring transdiagnostic aspects of mental health. Method: This study tackles these challenges by investigating network relations among core ED symptoms, comorbid clinical symptoms (depression and anxiety) and empirically supported vulnerability and protective mechanisms (personality traits, maladaptive cognitive schemata, perfectionism and resilience) in a sample of 2302 treatment-seeking ED patients. We estimated a regularized partial correlation network to obtain conditional dependence relations among all variables. We estimated node centrality (interconnectivity) and node predictability (the overall magnitude of symptom interrelationships). Results: The findings indicate a central role of overvigilance, excessive focus on inhibiting emotions and feelings, interoceptive awareness and perfectionism. Conclusions: These results suggest that excessive control of bodily aspects by dietary restraint (possibly through inhibition) and interoceptive awareness may be important constructs that warrant future research in understanding

A systematic review of network analysis studies in eating disorders: Is time to broaden the core psychopathology to non specific symptoms

“…Moreover, ineffectiveness and interoceptive awareness were identified in the shortest pathway between emotional abuse and drive to thinness or bulimic symptoms in people with AN restricting type and with AN purging type or BN, respectively. In accordance with this study, early maladaptive schema (over‐vigilance and inhibition of emotions and impaired autonomy and performance) were external field nodes resulting highly central in samples with mixed EDs (Vervaet et al., 2020), although their possible bridge role was not assessed. Another study (Monteleone, Corsi, et al., 2020) explored the connections of ED‐specific and affective symptoms with mentalizing and empathy, assessed through experimental tasks, and displayed emotional mental state inference and restraint as the bridge nodes between psychopathology and socio‐cognitive processes.…”

“…The high centrality of interpersonal difficulties has been highlighted also in other studies conducted in people with AN (Monteleone et al., 2019; Solmi et al., 2019) or in a mixed ED diagnostic group (Solmi et al., 2018). Furthermore, some studies identified also ineffectiveness feelings (Hilbert et al., 2020; Olatunji et al., 2018; Solmi et al., 2018; 2019; Vervaet et al., 2020), interoceptive awareness (Cascino et al., 2019; Olatunji et al., 2018; Solmi et al., 2018, 2019; Vervaet et al., 2020) or emotional regulation/internalising difficulties (Forrest et al., 2019; Levinson et al., 2017; Monteleone et al., 2019; Solmi et al., 2018, 2019; Vervaet et al., 2020) as central symptoms in ED networks. In most of these latter studies, drive to thinness as opposed to body dissatisfaction showed moderate‐high centrality and the Eating Disorder Inventory (EDI) instead of the EDE‐Q was employed.…”

“…This was the only study including data from multiple levels of assessment in an ED network. Finally, personality and identity variables were included in ED networks: trait characteristics resulted peripheral nodes in people with different ED diagnoses (Solmi et al., 2018, 2019; Vervaet et al., 2020) while feeling oneself through objective measures was a central node in people with AN (Cascino et al., 2019).…”

“…This limitation of network analyses is common to other statistical methods but may have contributed to the low reproducibility of network findings (Forbes et al., 2019). Only a few studies (Monteleone et al., 2019; Solmi et al., 2018; Vervaet et al., 2020) have included in their networks a broad range of general and ED‐specific symptoms, thus allowing to evaluate the centrality of each symptom taking into account the possible effect of all the internalizing symptoms which have been found associated to ED psychopathology (Marzola et al., 2020; Spindler & Milos, 2007). Therefore, this systematic review highlights the need in future studies for a theoretically driven selection of nodes, thus including general psychopathology and employing the suggested method (the goldbricker function) to ascertain the lack of overlapping between the network items and to inform their selection.…”

Efeito protetor do treino aeróbico em ratos submetidos à dieta hiperlipídica e normolipídica mensurados pela análise do perfil lipídico e do processo inflamatório tecidual / Protective effect of aerobic training in rats submitted to hyperlipidic and normolipidic diets measured by the analysis of lipid profile and tissue inflammatory process

“…Deve-se ressaltar que os possíveis mecanismos responsáveis pelo consumo calórico em animais não podem ser totalmente extrapolados para humanos adultos, que possuem outros fatores para desregular seu consumo calórico. Problemas de autoestima e inibição de emoções e sentimentos reduzem o consumo alimentar(VERVAET et al, 2020), enquanto que tristeza ou ansiedade estimulam seu aumento(BREWERTON et al, 2020).A maior concentração de HDL de PAE em relação a HAE pode ser apoiada estudo deJimenéz-Maldonado et al (2019), que observaram acúmulo hepático de colesterol gerado pela dieta hiperlipídica, o que inibe da expressão de ABC1 e reduz a produção de HDL. Além disso, o aumento da concentração sérica de triglicerídeos do subgrupo HAE em relação ao PAE e o aumento da quantidade de tecido adiposo do grupo H em relação ao P podem ser apoiados pelos achadosde Da Luz et al (2011), que observaram aumento da produção hepática de Lipoproteínas de Muito Baixa Densidade (VLDL) e do processo inflamatório no retículo endoplasmático (RE) causados pela dieta hiperlipídica, o que reduz a lipólise e a produção energética mitocondrial e aumenta o armazenamento de triglicerídeos no tecido adiposo.…”