Search Results (165)

Background/Objectives: A growing body of literature has demonstrated that living with food insecurity (FI) increases risk for mental health concerns in addition to nutritional deficits (e.g., suboptimal micronutrient consumption, excessive macronutrient consumption, malnutrition). Yet, research is needed to improve our understanding of subpopulations potentially at increased risk for mental health concerns when living in the context of FI. The current study examined psychosocial health across women of different developmental life stages all living with FI. Methods: Female clients of a large, urban food bank (N = 680) living with FI completed measures of mental health and health-related quality of life (HRQOL) in a cross-sectional design conducted on site at the food bank. Results: Consistent with past research, FI severity was correlated with poorer psychosocial health across all variables. A multivariate analysis of covariance compared women living with FI across 4 developmental life stages (young adult, early midlife, late midlife, and older adult; age range = 18–94 years), controlling for FI severity and race/ethnicity, on outcomes related to mental health and HRQOL. Women in early and late midlife reported higher anxiety, eating disorder symptoms, and eating-related psychosocial impairment than younger and older women. Conclusions: The mental health toll of living with FI is profound; midlife may comprise a developmental period of increased vulnerability to experience this mental health burden of living with FI for women. Thus, efforts are needed to develop innovative pathways for interventions to support the mental health of midlife women living with FI, likely involving multi-level and/or multicomponent approaches to resource access. Full article

Food addiction (FA) is an emerging psychiatric condition that presents behavioral and neurobiological similarities with other addictions, and its early identification is essential to prevent the development of more severe disorders. The aim of the present study was to determine the ability of anthropometric measures, eating habits, symptoms related to eating disorders (ED), and lifestyle features to predict the symptoms of food addiction. Methodology: A cross-sectional study was conducted in a sample of 702 university students (77.3% women; age: 22 ± 6 years). The Food Frequency Questionnaire (FFQ), the Yale Food Addiction Scale 2.0 (YFAS 2.0), the Eating Attitudes Test (EAT-26), anthropometric measurements, and a set of self-report questions on substance use, physical activity level, and other questions were administered. A total of 6.4% of participants presented symptoms compatible with food addiction, and 8.1% were at risk for ED. Additionally, 26.5% reported daily smoking, 70.6% consumed alcohol, 2.9% used illicit drugs, and 29.4% took medication; 35.3% did not engage in physical activity. Individuals with food addiction had higher BMI (p = 0.010), waist circumference (p = 0.001), and body fat (p < 0.001) values, and a higher risk of eating disorders (p = 0.010) compared to those without this condition. In the multivariate logistic model, non-dairy beverage consumption (such as coffee or alcohol), vitamin D deficiency, and waist circumference predicted food addiction symptoms (R²_Nagelkerke = 0.349). Indeed, the machine learning approaches confirmed the influence of these variables. Conclusions: The prediction models allowed an accurate prediction of FA in the university students; moreover, the individualized approach improved the identification of people with FA, involving complex dimensions of eating behavior, body composition, and potential nutritional deficits not previously studied. Full article

Background/Objectives: Muscle dysmorphia (MD), a subtype of body dysmorphic disorder, is prevalent among males who engage in the non-medical use of anabolic–androgenic steroids (AASs) and performance-enhancing drugs (PEDs). These individuals often experience severe psychopathology, including mood instability, compulsivity, and a distorted body image. Despite its clinical severity, no randomized controlled trials (RCTs) have evaluated structured psychological treatments in this subgroup. This study aimed to assess the efficacy of a manualized cognitive behavioral therapy (CBT) protocol in reducing MD symptoms and associated psychological distress among male steroid users. Results: Participants in the CBT group showed significant reductions in MD symptoms from the baseline to post-treatment (MDDI: p < 0.001, d = 1.12), with gains sustained at follow-up. Large effect sizes were also observed in secondary outcomes including depressive symptoms (PHQ-9: d = 0.98), psychological distress (K10: d = 0.93), disordered eating (EDE-Q: d = 0.74), and exercise addiction (EAI: d = 1.07). No significant changes were observed in the control group. Significant group × time interactions were found for all outcomes (all p < 0.01), indicating CBT’s specific efficacy. Discussion: This study provides the first RCT evidence that CBT significantly reduces both core MD symptoms and steroid-related psychopathology in men engaged in AAS/PED misuse. Improvements extended to mood, body image perception, and compulsive exercise behaviors. These findings support CBT’s transdiagnostic applicability in addressing both the cognitive–behavioral and affective dimensions of MD. Materials and Methods: In this parallel-group, open-label RCT, 59 male gym-goers with DSM-5-TR diagnoses of MD and a history of AAS/PED use were randomized to either a 12-week CBT intervention (n = 30) or a waitlist control group (n = 29). CBT sessions were delivered weekly online and targeted distorted muscularity beliefs, compulsive behaviors, and emotional dysregulation. Primary and secondary outcomes—Muscle Dysmorphic Disorder Inventory (MDDI), PHQ-9, K10, EDE-Q, EAI, and BIG—were assessed at the baseline, post-treatment, and 3-month follow-up. A repeated-measures ANOVA and paired t-tests were used to analyze time × group interactions. Conclusions: CBT offers an effective, scalable intervention for individuals with muscle dysmorphia complicated by anabolic steroid use. It promotes broad psychological improvement and may serve as a first-line treatment option in high-risk male fitness populations. Future studies should examine long-term outcomes and investigate implementation in diverse clinical and cultural contexts. Full article

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: During exam sessions, many students experience high levels of stress caused by the large volume of material to study, tight deadlines, and pressure to achieve top grades. This study aimed to examine the relationship between academic stress, sleep disturbances, and eating behaviors by using validated questionnaires administered to a student sample. As stress levels increased, the data revealed a higher frequency of insomnia symptoms and disordered eating, including behaviors such as compulsive eating and irregular meal patterns. Materials and Methods: This cross-sectional, correlational study was conducted on a convenience sample of 317 university students from various academic centers across Romania. Participants were recruited via online distribution of a self-administered questionnaire during a four-month period, including exam sessions. The survey included the Perceived Stress Scale (PSS), the Insomnia Severity Index (ISI), and the Eating Disorder Examination Questionnaire (EDE-Q), alongside additional items assessing perceived links between stress, sleep, and eating behaviors, and the use of medication. Data were analyzed using SPSS with Spearman correlations, t-tests, and linear regression. Results: Statistical analyses revealed significant and positive associations between perceived stress levels and insomnia, as indicated by Spearman’s correlation (p < 0.01). A similar significant correlation was identified between perceived stress and disordered eating behaviors among students. Specifically, the feeling of being overwhelmed by academic workload showed a strong positive correlation with a lack of control over eating behaviors (r = 0.568). Furthermore, linear regression analysis confirmed a significant predictive relationship between feeling overwhelmed and the tendency to eat excessively beyond initial intentions, with a standardized regression coefficient B = 0.581 (p < 0.001). A separate regression analysis focusing on exam-related stress and episodes of compulsive eating behavior demonstrated a comparable result (B = 0.573, p < 0.001), indicating a robust positive association. Additionally, independent samples t-tests demonstrated that students experiencing high levels of stress during the exam period reported significantly greater difficulties with sleep initiation and higher levels of disordered eating compared to their peers with lower stress levels. The difference in insomnia scores was highly significant (t = 11.516, p < 0.001), as was the difference in eating behavior scores (t = 10.931, p < 0.001). Conclusions: These findings underscore the need for emotional support services and effective stress management strategies, enabling students to navigate academic demands without compromising their mental or physical well-being. 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: Although mental health among students has become a pressing public concern over recent years, the COVID-19 pandemic introduced new stressors, which may further increase the mental health burden for them. While past work has investigated links between pandemic related factors and student mental health and wellbeing, there is conflicting evidence around some symptoms (e.g., anxiety) and little work has focused on less common mental health conditions (e.g., eating disorders). Aims: The current study aimed to detail the prevalence of mental distress in the student population at an early stage of the COVID-19 pandemic and compare university students’ mental health before and during the COVID-19 pandemic. Specifically, we aimed to compare levels of depression, anxiety, and eating disorders in a large sample of students. Methods: We analysed data from a repeated cross-sectional survey on different samples of UK university students before the pandemic (n = 4812) and during the pandemic (n = 3817). Results: There were high levels of depression and anxiety during the COVID-19 pandemic, with more than 50% experiencing levels above the clinical cut-offs. Findings revealed a significant increase in symptoms of depression and anxiety from pre- to mid-pandemic as well as a significant increase in the prevalence of eating disorders. Conclusions: By late 2020, mental health in the student population had deteriorated compared to pre-pandemic levels. These findings provide evidence for increased levels of depression, anxiety, and eating disorders related to the COVID-19 pandemic. There is a need for better preparedness for future crises in order to mitigate the impact on student mental health. 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

Introduction: Childhood emotional maltreatment, which includes emotional abuse and neglect, has been identified as a significant risk factor for the development of disordered eating behaviors related to overeating and reduced dietary control. At the same time, the literature suggests that childhood emotional maltreatment appears to be linked to deficits in reflective functioning which, in turn, may increase vulnerability to dysregulated, impulsive, and addictive behaviors. However, to date, the role of a key factor, such as food addiction (FA), within this model has not yet been investigated. Therefore, the aim of this study was to test a mediation model in which emotional abuse and neglect predict overeating and reduced dietary control through deficits in reflective functioning and FA symptoms. Method: Using a cross-sectional design, a conventional non-clinical sample of 543 participants was recruited and completed a set of standardized questionnaires. A multiple mediation model with observed variables was specified (10,000 bootstrap resampling). Results: The multiple mediation model showed good results, confirming the initial hypotheses. Specifically, emotional abuse and neglect were associated with FA symptoms through deficits in reflective functioning. In turn, FA symptoms predicted overeating behaviors and poor dietary control. Discussion: These findings highlight the central role of FA in linking reflective functioning deficits to disordered eating patterns associated with excessive food consumption. This study advances our understanding of the psychological mechanisms underlying disordered eating behaviors and underscores the need for targeted interventions addressing reflective functioning deficits and food addiction in individuals with a history of childhood emotional maltreatment. Full article

Background: Accurately assessing eating disorder (ED) severity and treatment progress is essential for effective intervention. The Comprehensive and Continuous Tool to Assess Severity and Improvement of Eating Disorders (CONTASI-ED) was developed to address limitations in existing assessments by incorporating behavioral, cognitive, and physiological markers. Objectives: This study aimed to examine the psychometric properties and sensitivity to symptom changes of the CONTASI-ED in a community-based clinical sample of women with ED. Methods: Participants were 58 females diagnosed with EDs and 10 healthy controls. The CONTASI-ED assessments were conducted over multiple time points in outpatient and intensive treatment settings. We examined reliability, validity, and sensitivity to treatment-related change. The CONTASI-ED scores were compared with EAT-26, and multivariable analyses explored the effects of body mass index (BMI), age, and post-traumatic stress disorder (PTSD) on symptom trajectories. Results: The CONTASI-ED demonstrated strong reliability, with test–retest correlations between 0.72 and 0.90 and inter-rater reliability of 0.68–0.95. The tool effectively distinguished ED patients from healthy controls (p < 0.001) and correlated strongly with EAT-26. Significant reductions in the CONTASI-ED scores over time (p < 0.001) reflected treatment-related improvements—although temporary score increases highlighted greater self-awareness and symptom disclosure. BMI, age, and PTSD significantly influenced symptom severity and treatment response. Conclusions: The CONTASI-ED demonstrated strong reliability and validity in distinguishing clinical and non-clinical cases and in tracking treatment-related changes. However, the findings are based on a relatively small, all-female sample, underscoring the need for further validation in more diverse populations. Full article

Objectives: Feeding and eating disorders (FED) represent a major public health issue and are the second leading cause of death among psychiatric conditions in children and adolescents. Psychopathological comorbidities play a significant role in the onset and persistence of FED, yet research on their underlying structure remains limited. This study explores the psychiatric comorbidities associated with FED, focusing on common etiopathogenetic factors and their clinical implications. Methods: Data were retrospectively collected from the Italian Regional Center for FED in the Emilia-Romagna Region between June 2023 and April 2024. Diagnoses were assigned following DSM-5 criteria using the Italian version of the semi-structured K-SADS-PL diagnostic interview. Principal component analysis (PCA) was performed to identify latent psychological dimensions underlying FED psychopathology, retaining five components based on the scree plot. Additionally, an analysis of covariance (ANCOVA) was conducted to examine differences in factor scores across FED subtypes, while adjusting for potential confounders. Results: Seventy-two participants were included (mean age: 14.6 years; mean BMI: 18.3 kg/m²; male-to-female ratio: 1:8). Diagnoses were distributed as follows: 63.9% anorexia nervosa (AN), 13.9% other specified feeding and eating disorder (OSFED), 6.9% avoidant restrictive food intake disorder (ARFID), 4.2% binge eating disorder (BED), 4.2% unspecified feeding and eating disorder (UFED), and 2.7% bulimia nervosa (BN). All participants met the criteria for at least one psychiatric comorbidity. Identified psychopathological clusters include the following: (1) mood disorders (66.5%); (2) anxiety disorders (87.5%); (3) obsessive–compulsive and related disorders (47.2%); (4) neurodevelopmental disorders, i.e., attention-deficit/hyperactivity disorder (ADHD) (30.5%); (5) disruptive and impulse-control disorders (13.9%); and (6) psychotic symptoms (40.3%). No instances of tic or elimination disorders were detected. Conduct disorder was more prevalent among UFED, BED, and BN patients compared to other FED (p = 0.005), and moderate/severe ADHD was associated with higher body mass index (BMI) (p = 0.035). PCA revealed distinct psychological dimensions underlying FED, while ANCOVA indicated significant differences in factor scores across FED subtypes, supporting the presence of shared transdiagnostic mechanisms. Conclusions: This study highlights the complex interplay between FED and psychiatric comorbidities, emphasizing the need for early intervention and personalized treatment approaches. The dimensional structure identified through PCA suggests that common psychopathological factors may drive FED development, and ANCOVA findings support their differential expression across FED types. Future research should further investigate these transdiagnostic mechanisms to optimize clinical care. Full article

Background/Objectives: Pressure to stay lean may lead adolescent athletes to dietary restraint and disordered eating. Lack of nutrition awareness can also contribute to suboptimal dietary habits, increasing the risk of eating disorders and Relative Energy Deficiency in Sport [RED-S], though evidence in competitive athletes is limited. This study explored eating disorder symptoms and RED-S knowledge in adolescent artistic gymnasts. Methods: Eighty-four female artistic gymnasts, thirty-nine international and national level gymnasts [high-level; 14 [14, 15] y] and forty-five recreational and club level gymnasts [low-level; 14 [13, 15] y] completed the Eating Disorder Examination Questionnaire [EDE-Q 6.0], the RED-S knowledge Questionnaire and provided training details. Results: Seventeen gymnasts (20.2%) scored above the cutoff point on the EDE-Q. In addition, high-level gymnasts scored higher than low-level on EDE-Q [2.21 ± 1.37 (35.9%) vs. 1.19 ± 0.79 (6.7%), respectively; p < 0.001] and on its subscales: Restraint, Eating Concerns, Weight Concerns, and Shape Concerns [p < 0.001 to 0.009], thus indicating more severe disordered eating symptoms. No group differences were found in binge eating and compensatory behaviors. An important percentage of gymnasts reported at least one episode of binge eating and excessive training [39.3–58.3%], while four gymnasts reported self-induced vomiting. RED-S knowledge did not differ between groups. On average, gymnasts were unaware of correct answers related to RED-S [51.5%], its definitions [79.8–92.9%], and its association with menstrual disturbances and bone health [54.8–86.9%]. However, gymnasts reported better awareness of the impact of food restriction on illness and performance [47.6–84.5%]. Conclusions: Elite artistic gymnasts exhibited a higher prevalence of eating disorder symptoms than lower-level peers. Gymnasts at all levels demonstrated limited knowledge of the effects of RED-S on menstrual and bone health. Failure to recognize these risks may influence gymnasts’ eating behaviors and delay RED-S detection and management. 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

Background/Objectives: Eating disorders (EDs) are associated with cognitive inefficiencies related to cognitive flexibility, central coherence, and inhibition. Transdiagnostic cognitive remediation therapy (TCRT) is a new adaption of cognitive remediation therapy aimed at addressing these difficulties across ED diagnoses. This study investigates the effects of TCRT as an adjunctive treatment for patients with EDs on cognitive and clinical outcomes. Methods: A randomized controlled trial compared the effect of 9 individual sessions of TCRT in conjunction with treatment as usual (TAU) compared to TAU only for patients with EDs and concurrent cognitive difficulties. Participants were assessed at baseline, post-treatment (12 weeks after baseline), and follow-up (6 months after post-treatment assessment). The outcome measures included neuropsychological tests and self-report questionnaires measuring cognitive difficulties and ED psychopathology. The analysis was in accordance with intention to treat principles. Results: Sixty patients with various ED diagnosis and concurrent cognitive difficulties were recruited. The TCRT group (n = 30) displayed significantly greater improvement in self-reported executive functioning, measured by the Behavior Rating Inventory of Executive Function—Adult version compared to the control group (n = 30). However, no superiority of TCRT was observed on performance-based measures of set shifting, central coherence, or inhibition. Moreover, there was no significant difference in improvement in self-reported ED psychopathology. Conclusions: TCRT may enhance compensatory mechanisms for cognitive inefficiencies rather than improve cognitive effectiveness or ED symptoms directly for patients with EDs and concurrent cognitive difficulties. Further investigation of how these impact everyday functioning may provide valuable insights into TCRT’s role in ED treatment. Full article