Search Results (113)

Aims. In the present study, we investigated the associations between the three identity dimensions of Kaufman (Consolidated Identity, Disturbed Identity, Lack of Identity) and symptoms of personality disorders (PDs) in 176 female inpatients with an eating disorder (ED). We examined five aspects: the prevalence of categorical PD diagnoses in patients with EDs; the relationship between dimensional PD scores and identity dimensions as well as their relationships with age and ED subtype; and the unique variance in dimensional PD scores explained by identity dimensions, while controlling for age and ED subtype. Methods. To assess identity functioning, we made use of the Self-Concept and Identity Measure, and to assess PDs, we used the categorical and dimensional scores of the Assessment of DSM-IV Personality Disorders. Results. The findings showed that the avoidant, obsessive–compulsive, and borderline categorical PDs were the most frequently reported PDs. Age was negatively related to all Cluster B PDs and Disturbed Identity, and binge-eating/purging ED patients reported significantly more Cluster B PD features compared to restrictive ED patients. ED subtype and identity dimensions were unrelated. Correlational analysis showed that all dimensional PD scores were positively related to Disturbed Identity and Lack of Identity and negatively related to Consolidated Identity. The results of the hierarchical regression analyses showed that Cluster A PDs were significantly predicted by Lack of Identity, controlled for age and ED subtype. Additionally, Cluster B PDs were significantly predicted by Disturbed Identity. Finally, two of the three cluster C PDs were predicted by Lack of Identity (avoidant and obsessive–compulsive PD), whereas the dependent PD was explained by Disturbed Identity. Conclusions. The co-occurrence of identity issues in both PDs and EDs underscores the role of identity as a transdiagnostic feature. Accordingly, using identity-based interventions in treatment may have broad therapeutic benefits across these disorders. Full article

Background and Objectives: Excessive social media use is repeatedly linked to negative body image outcomes, yet its association with muscle dysmorphia, especially in athletic youth, remains underexplored. We investigated how social media exposure, comparison behavior, and platform engagement relate to muscle dysmorphia symptomatology in young German athletes. Materials and Methods: An anonymous, web-based cross-sectional survey was conducted (July–October 2024) of 540 individuals (45% female; mean age = 24.6 ± 5.3 years; 79% ≥ 3 h sport/week) recruited via Instagram. The questionnaire comprised demographics, sport type, detailed social media usage metrics, and the validated German Muscle Dysmorphic Disorder Inventory (MDDI-1, 15 items). Correlations (Spearman’s ρ, Kendall’s τ) were calculated; multivariate importance was probed with classification-and-regression trees and CatBoost gradient boosting, interpreted via SHAP values. Results: Median daily social media time was 76 min (IQR 55–110). Participants who spent ≥ 60 min per day on social media showed higher MDDI scores (mean 38 ± 7 vs. 35 ± 6; p = 0.010). The strongest bivariate link emerged between perceived social media-induced body dissatisfaction and felt pressure to attain a specific body composition (Spearman ρ = 0.748, Kendall τ = 0.672, p < 0.001). A CatBoost gradient-boosting model out-performed linear regression in predicting elevated MDDI. The three most influential features (via SHAP values) were daily social media time, frequency of comparison with fitness influencers, and frequency of “likes”-seeking behavior. Conclusions: Intensive social media exposure substantially heightens muscle dysmorphia risk in young German athletes. Machine-learning interpretation corroborates time on social media and influencer comparisons as primary drivers. Interventions should combine social media literacy training with sport-specific psychoeducation to mitigate maladaptive comparison cycles and prevent downstream eating disorder pathology. Longitudinal research is warranted to clarify causal pathways and to test targeted digital media interventions. Full article

Background: The rising focus on dietary choices has contributed to maladaptive eating patterns, including orthorexia nervosa (ON)—a pathological preoccupation with healthy eating. This study investigated ON prevalence and correlates in two Polish young adult cohorts to address inconsistencies in the existing literature and ON’s ambiguous nosological status. We explored its complex interplay with specific lifestyle and sociodemographic factors. Methods: The study sample consisted of 412 young adults, comprising Group 1 (G1; n = 136; 95 women, 38 men, and 3 non-binary individuals) and Group 2 (G2; n = 264; 194 women, 65 men, and 5 non-binary individuals). Data collection utilized a proprietary questionnaire for sociodemographic and health, the ORTO-15 questionnaire (cut-off < 35 points) for ON risk, and the EAT-26 for eating disorder (ED) risk. Depression was self-assessed. An analysis of sociodemographic, clinical, and lifestyle data was conducted to explore the association with orthorexia risk. Results: ON risk was identified in 26.5% of participants in G1 and 76.8% in G2. Logistic regression analysis identified different, independent predictors of ON risk for each group. In G1, these were depressive symptoms (OR = 2.52) and a co-occurring risk of eating disorders (ED) (OR = 11.37). In contrast, for G2, the predictors were smoking (OR = 2.14) and, inversely, a lower ED risk (OR = 0.16). No consistent associations were found with ON risk and age, gender, education, residence, or occupational status. Conclusions: This study confirms a strong link between ON and other eating disorders. The high ON prevalence in G2, combined with low internal consistency of ORTO-15, suggests tool limitations in specific populations. These findings highlight the need for more precise ON diagnostic tools and further research into its correlates, including body image, specific lifestyle factors, and its role within eating pathology. Full article

Background/Objectives: The prevalence of orthorexia nervosa (ON) is increasing over time. Additionally, specific social categories seem to be more affected. In the literature, the prevalence of university students suffering from ON is unclear, ranging from 7% to 83%. Nonetheless, ON shares pathological traits with both eating and obsessive–compulsive disorders, making its etiology and therapeutic perspectives complex. This study aimed to investigate the prevalence of ON and explore its psychological characteristics in a sample of university students. Methods: A total of 205 students from the University of Parma were consecutively recruited using a convenience sampling procedure. Participants completed the Orthorexia Nervosa Questionnaire-15 (ORTO-15) to assess ON, the Eating Disorder Inventory-3 (EDI-3) to investigate eating behavior, the Symptom Checklist-90-Revised (SCL-90-R) to detect psychological symptoms, and the P Stress Questionnaire (PSQ) to describe stress-related lifestyle. Based on the scores obtained on the ORTO-15, a group of orthorexic students (ORTO-15 score ≤ 35) was compared with a group of non-orthorexic students (ORTO-15 score > 35). Results: The prevalence of university students with ON was nearly 42% (specifically, 41.95%). Furthermore, orthorexic students reported significantly higher levels of emotional dysregulation, perfectionism, and asceticism on the EDI-3 as well as affective problems and overcontrol in general. Furthermore, although there were no differences between the groups regarding psychological symptoms, an increase in sense of responsibility, vigor, and hyperactivity, as well as decreased free time on the PSQ, characterized the orthorexic student group. Conclusions: The results support that orthorexia nervosa emerged as a concerning phenomenon among university students, with increasing evidence pointing to its psychological correlates. Nonetheless, the fact that ON shares psychological characteristics with eating disorders highlights the clinical importance of implementing multidimensional assessments and multidisciplinary therapeutic approaches for individuals presenting with orthorexic-type eating behavior disorders. Full article

Background/Objectives: Although regular physical exercise is protective for health, excessive engagement can contribute to the development of addiction. Further, the co-occurrence of exercise addiction (EA) and disordered eating (DE) is very frequent among athletes with several common risk factors. Our study focused on the associations between exercise addiction, eating attitudes, body appreciation, and perfectionism in a sample of physically active adults. Methods: Using a sample of Hungarian adults who were regular exercisers (n = 205, aged 18–70 years, mean age = 30.59 years; 77.1% females), cluster analysis was applied to identify participants’ profile according to their level of EA, DE attitudes, body appreciation, and dimensions of perfectionism. Results: Healthy exercisers had the second lowest level of EA and highest level of body appreciation, and they were not prone to DE (31.22%). Another cluster had a relatively low risk of EA but were potentially prone to DE, with poor body appreciation and a medium level of socially prescribed and other-oriented perfectionism (29.8%). Third, a group of exercisers was characterized by the highest risk of both EA and DE, who also reported relatively high levels of personal standards and organization (25.36%). Finally, those with the second highest risk of EA with a high tendency for dieting and bulimia and poor body appreciation were prone to socially prescribed and other-related perfectionism (13.66%). Conclusions: Symptoms of exercise addiction are not necessarily pathological, but they can serve as signals for the overuse of sports and undue achievement orientation, particularly when being associated with disordered eating attitudes. Full article

Background: Excessive daytime sleepiness (EDS) and fatigue are two impactful symptoms, frequently associated with sleep disorders, which can worsen the quality of life. Due to overlapping features and patient-report ambiguity a clear-cut distinction between EDS and fatigue can become a challenging issue. We aimed to investigate the prevalence and consequences of these two conditions in several sleep pathologies, examining their social, psychological, and dietary impact, with a focus on gender-related differences and occupational status. Methods: We prospectively recruited for an online survey 136 adult outpatients (60 females) affected by various sleep disorders and admitted to our Sleep Disorders Center in Parma, Italy. Patients were asked to complete the following tests: Epworth Sleepiness Scale, Fatigue Severity Scale, Pittsburgh Sleep Quality Index, Difficulties in Emotion Regulation Scale, Depression Anxiety Stress Scale-21, Hyperarousal Scale, the Addiction-like Eating Behaviors Scale, Work Productivity and Activity Impairment Questionnaire, MEDI-Lite, and EQ-5D Health Questionnaire. Results:Fatigue was the primary daily symptom leading to serious repercussions on social/emotional and psychological well-being, while daytime sleepiness showed a less relevant role. Women reported higher levels of fatigue, sleep disturbances, emotional dysregulation, hyperarousal, and work productivity impairments. Unemployed people experienced a higher degree of fatigue, with multi-level negative consequences. Conclusions: We suggest sleep clinicians place a greater emphasis on the assessment of fatigue during clinical interviews, keeping in mind the greater vulnerability of females, experiencing disproportionate consequences. Further studies should expand our findings, exploring a wider range of gender identities and recruiting larger samples of patients. Full article

Background: Autistic women with eating disorders (EDs) often present with more complex EDs and may not fully benefit from current treatments, yet the reasons for this remain unclear. This study aims to examine the eating behaviors of autistic women with EDs and how these differ from those of (1) non-autistic women with EDs, (2) autistic women without EDs, and (3) non-autistic female controls. It investigates autism-related eating behaviors, traditionally disordered eating behaviors, and avoidant–restrictive food intake disorder (ARFID)-related behaviors to better understand their complex ED presentations. Methods: A cross-sectional study was conducted with 30 autistic women with EDs, 30 non-autistic women with EDs, 29 autistic women without EDs, and 60 non-autistic female controls. Participants completed questionnaires assessing eating behaviors, quality of life, and comorbid psychological symptoms. Results: Autistic women with EDs exhibited higher levels of both autism-related and disordered eating behaviors than all other groups, including food selectivity, mealtime rigidity, and sensory-related eating difficulties. They also reported notable weight and shape concerns. Additionally, they showed higher levels of comorbidity and reported lower mental health-related quality of life compared to all other groups. Conclusions: These findings suggest that the overlap of autism-related and disordered eating behaviors contributes to the complexity and severity of EDs in autistic women, potentially limiting the effectiveness of current treatment approaches. Developing autism-informed interventions that address sensory sensitivities, rigidity, and cognitive differences may improve treatment outcomes. Future research should explore how these factors interact in maintaining ED pathology and identify strategies to distinguish adaptive from maladaptive eating behaviors. Full article

The literature describes an increased risk of eating disorders (EDs) in patients with Type 1 diabetes mellitus (T1DM) compared to the general population. This risk is mainly related to physical and psychosocial problems related to diabetes. EDs should be carefully assessed and treated in these patients since they are associated with poor glycemic control and significant repercussions of pathology. Background/Objectives: To study the presence of EDs in young Portuguese adults and adults with T1DM, and how gender; age group; method of insulin administration; carbohydrate counting; and body mass index [BMI] variables influence the risk of developing an ED. Methods: Data collection was carried out using an online questionnaire, which was disseminated through the media of several Portuguese diabetes associations. Results: The sample consisted of 47 participants, mostly female, with the age group between 26 and 35 years being most representative. A statistically significant association was found between the Eating Attitudes Test [EAT-26] scores and the BMI of the participants [p = 0.003]; other variables did not show statistically significant differences. Conclusions: To better understand the relationship between these two pathologies, further studies are needed, as well as the development of more screening instruments to assess the risk of EDs specific to T1DM, and preventive interventions and guidelines that can assist the various areas of health that support the population with T1DM. Full article

Nowadays, social media and rapidly changing dietary trends encourage people to constantly—often excessively—control their diet, which leads to an increased risk of developing eating disorders, including orthorexia nervosa (ON). At the same time, more and more people reduce or give up consumption of meat and other animal products, adopting different types of plant-based (vegetarian) diets. The following paper aimed to demonstrate the significant similarities between orthorexia and plant-based diets and to highlight the necessity of developing new or adapting existing diagnostic tools for orthorexia considering the lifestyle characteristics of vegetarians, especially vegans. It remains unclear whether vegetarianism increases the risk of developing ON or whether the development of ON increases the chances of switching to a plant-based diet. However, based on the available literature, a positive association can be shown between the two. On the one hand, a vegetarian diet may be a cover for ON, but on the other, vegetarians, as a group avoiding specific food products, may be wrongly perceived as disordered. Thus, it is important to distinguish ON from the so-called healthy orthorexia (HO), which is a non-pathological interest in healthy eating, to avoid overdiagnosis and stigmatization of people using healthy alternative diets, including plant-based diets, since the mere fact of following them does not constitute evidence of orthorexia. Full article

Background/Objectives: Fasting and physical exertion positively affect body mass and composition. This study aimed to examine the effects of physical changes induced by eight days of water-only fasting and a physical exertion test and their influence on body satisfaction and body image parameters in middle-aged men. Methods: Fifteen participants were assessed for physical (height, body mass, and body composition) and psychological (body satisfaction, evaluation of body parts, and body image determinants) aspects before and after the fasting intervention, both at rest and post-exercise. Correlation and concordance coefficients were calculated for the analyzed variables. Results: It was found that the fasting intervention led to a reduction in body mass and a favorable shift in body composition, while also increasing satisfaction with one’s body and its specific parts. This positively impacted volunteers’ self-assessment of their health status. Selected body image parameters remained at an average level for the male population and did not change following the fasting. Attitudes toward body weight control methods and their perceived effectiveness did not change either. Participants favored reducing food intake and eliminating high-calorie products from their diet, rejecting the use pathological methods typically associated with eating disorders. A few associations between physical and psychological aspects of corporeality were observed, whereas significant correlations between satisfaction with body parts and parameters and a positive body image were confirmed. Conclusions: The above suggest that physical conditions and their changes resulting from fasting and physical exertion lead to a positive influence on body satisfaction and its components but do not alter body image. Full article

Background/Objectives: Childhood trauma is associated with psychiatric sequelae beyond post-traumatic stress disorder (PTSD), including eating disorders (EDs) and cognitive dysfunction. While eating pathology is related to cognition irrespective of childhood trauma exposure, such experiences may influence the way in which these symptoms develop. One method that has garnered increased interest in studying the interrelationships between symptoms and pinpointing core features of psychopathology is network analysis. Methods: Using data from the Nathan Kline Institute Rockland Sample, the present study utilized network analysis to examine associations between ED symptoms and cognitive deficits among a community sample. Comorbidity networks were constructed in two samples: adult reporters of childhood trauma (n = 116) and non-reporters (n = 101). Results: In line with the cognitive-behavioral model of EDs, overvaluation of weight/shape was central to both networks but demonstrated higher strength centrality among trauma reporters. Additionally, among trauma reporters, executive functioning deficits were linked to food-related attentional biases; alternatively, affective symptoms were salient among non-reporters. Finally, negative self-concept (theorized as a putative consequence of cognitive deficits) was implicated in both networks. When comparing the networks according to global strength, we did not find significant differences. Conclusions: Our findings contribute to the literature examining the interrelatedness of eating pathology and cognition and extend these findings by considering the role of trauma exposure. While our networks shared features of overvaluation of weight/shape and negative self-concept, they differed according to cognitive-affective concomitants. This information holds clinical utility in advancing assessment and intervention for individuals with eating psychopathology. Full article

Background/Objectives: There is a limited body of evidence regarding dietary intake in children with inflammatory bowel disease despite increasing research about the nutritional implications in the disease pathogenesis. Functional abdominal pain disorders (FAPDs) are also chronic disorders marked by chronic abdominal pain, currently described with the ROME IV criteria. This study was aimed to investigate the adherence to healthy eating habits in an inflammatory bowel disease pediatric population when compared to a matched population with functional abdominal pain gastrointestinal disorders. Methods: We performed a single centre study focused on dietary patterns in children with IBD and FAPDs between January 2021 and April 2024. Data collected included general information, disease phenotype, and the KIDMED index regarding healthy eating. Results: The final analysis was based on full data from the KIDMED index available for 122 (57 vs. 65) participants. Overall, the average KIDMED score did not vary significantly between the study population, meaning 6.89 ± 2.33 for the IBD group and 7.11 ± 2.67 for FAPDs group, p = 0.34. In the same KIDMED index group, mean values were higher for FAPDs patients, but results differ statistically significant only for “medium” adherence to healthy diet, showing that larger proportion of IBD patients were previously exposed to non-healthy diets: 8.99 vs. 11.1, p = 0.45, 5.02 vs. 6.92, p = 0.05, 2.89 vs. 2.56, p = 0.43, for group 1, 2, and 3, respectively. Conclusions: This study showed in our cohort that overall adherence to a healthy pattern diet is poor prior to diagnosis of different gastrointestinal pathologies in children. Full article

Background/Objectives: Binge Eating Disorders are severe mental and physical health conditions, closely linked to lifestyle habits. The aims are to describe the prevalence of Binge Eating Disorders and their correlation with nutritional habits and lifestyle factors within the Spanish population. Methods: A descriptive, cross-sectional design was employed. Using non-probabilistic snowball sampling, an electronic survey was released. A total of 22,181 Spanish adults were evaluated, excluding those with any pathology or limitation at the time of survey response that could potentially affect their diet, such as hospitalization or confinement. The validated Nutritional and Social Healthy Habits (NutSo-HH) scale was used to collect data on nutrition, lifestyle, health habits, and socio-demographic variables. Descriptive and inferential statistics were used. Non-parametric tests were applied due to non-normal distribution. Results: Of the 22,181 sample subject (80.8% female), a total number of 260 individuals reported Binge Eating Disorder. The prevalence of Binge Eating Disorder was higher in women than in men (239 vs. 21 respectfully; 91.9%). Individuals with Binge Eating Disorder exhibited poorer nutritional indices (p < 0.001), higher consumption of ultra-processed and fast food (p < 0.001), sugary soft drinks (p = 0.01), and worse sleep quality (p < 0.001). Although time dedicated to physical activity was not different, individuals with Binge Eating Disorder were more sedentary and had lower health status (p = 0.11 for sport practice). Behavioral regulation plays a key role in managing BED, highlighting the need for personalized intervention strategies. Conclusions: Binge Eating Disorders are associated with lifestyle and health habits and worse quality of life. These data can help design public health programs for early detection and effective treatment. Full article

Background/Objectives: Adolescence is a developmental stage characterized by profound physical and psychological transformations, often leading to vulnerabilities such as body dissatisfaction, identity challenges, and the use of maladaptive coping strategies. This often leads to body-related psychopathologies, including headaches, restrictive eating disorders, and non-suicidal self-injury (NSSI). The present study aimed to describe the typical functioning and features of these conditions and the differences between the three groups, and to identify the most effective assessment for predicting these conditions. Methods: Sixty adolescent patients (51 female; mean age = 15.34 ± 1.80) were divided into three groups: headaches, restrictive eating disorders, and NSSI, and assessed for differences in symptoms, cognitive performance, personality, functioning, and illness severity using semi-structured interviews, clinician-based scales, and performance-based tests like the Rorschach inkblot test, according to the Rorschach Performance Assessment System (R-PAS). Results: Individuals with headaches experienced more internalizing symptoms, had an average IQ, maintained some functioning areas, and had distorted patterns of self–other relationships with the tendency to project malevolent aspects onto others. Patients with restrictive eating disorders had high levels of depressive symptoms, above-average IQ scores, negative symptoms, moderate presence of obsessive–compulsive personality traits, disorganized thinking, and a tendency to interpret situations subjectively. Patients with NSSI showed the highest level of depressive symptoms and social anxiety symptoms, and a considerable presence of psychotic symptoms and perceptual distortions. Negative symptoms, borderline personality traits, and psychosis symptoms had the strongest predictivity. Conclusions: The study provides clinicians with relevant insights into the features of these conditions and highlights assessment strategies, tailored interventions, and enhanced outcomes for these vulnerable populations. Full article

Mental disorders (MDs) are among the major causes of morbidity and mortality worldwide. Individuals with severe MDs have a shorter life expectancy, primarily due to cardiovascular diseases. Echocardiography facilitates the evaluation of alterations in cardiac morphology and function, resulting from various cardiac pathologies. The aim of this review was to explore the current evidence base behind the myocardial deformation observed in echocardiography in patients with MDs. We primarily focused on the data regarding speckle tracking echocardiography. PubMed, using medical subject headings, was searched to identify studies on this topic. The collected data demonstrated changes in myocardial function in schizophrenia, bipolar disorder, depression, anxiety disorder, stressor-related disorder, post-traumatic stress disorder, eating disorders, sleep–wake disorders, substance-related and addictive disorders, neurocognitive disorders, and borderline personality disorder. The recurrent findings included impaired Left Ventricular Ejection Fraction and Left Ventricular Hypertrophy. Global Longitudinal Strain was significantly altered in patients with anorexia nervosa, bipolar disorder, and substance-related disorders. All reported studies support the consideration of cardiology consultations and a multidisciplinary approach in the care of patients with MDs with suspected cardiac dysfunction. Further investigation is warranted to determine the significance and prognostic value of myocardial deformation and strain measurements among individuals with MDs, focusing on the value of early detection, especially in asymptomatic cases. Full article