Are eating disorders "all about control?" : The elusive psychopathology of nonfat phobic presentations

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2017
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Murray, Helen B.
Coniglio, Kathryn
Becker, Anne E.
Eddy, Kamryn T.
Thomas, Jennifer J.
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International Journal of Eating Disorders. Wiley-Blackwell. 2017, 50(11), pp. 1306-1312. ISSN 0276-3478. eISSN 1098-108X. Available under: doi: 10.1002/eat.22779
Zusammenfassung

Objective:
There are a subset of individuals with eating disorders (EDs) who do not overevaluate body shape/weight (i.e., nonfat phobic ED; NFP-ED). According to the transdiagnostic cognitive–behavioral conceptualization of EDs, a need for control, in general, is hypothesized as the core psychopathology of NFP-EDs, with shape- and weight-related motivations for ED behavior merely superimposed in FP-ED presentations. This study tested the need for control as motivation for restriction in NFP-ED, using items aimed at assessing control from the Eating Disorder Examination (EDE) Restraint scale.

Method:
Females ages 13–27 years consecutively admitted to residential treatment completed the EDE, Eating Disorder Inventory-3 Drive for Thinness subscale (EDI-DFT), and other self-report measures of psychopathology. We included patients with DSM-5 EDs, but excluded patients with avoidant/restrictive food intake disorder. Twenty participants had NFP-ED (≤14 on EDI-DFT) and 124 had fatphobic ED (FP-ED; >14 on EDI-DFT).

Results:
NFP-ED scored significantly lower than FP-ED on EDE Restraint scale shape/weight [χ2(1) = 10.73–35.62, p's < .01] and on control items [χ2(1) = 10.72–20.62, p's < .01], in addition to scoring lower on measures of general psychopathology and impairment.

Discussion:
Findings suggest those with NFP-ED report lower psychopathology overall and the new EDE Restraint scale control items do not capture additional motivation for restriction beyond that captured in the original Restraint scale shape/weight items. Future research should examine whether this latter finding is due to a minimizing response style in NFP-ED, an incomplete capture of desire for control by the EDE assessment method, or indeed reflects that need for control does not motivate restriction in NFP-EDs.

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ISO 690MURRAY, Helen B., Kathryn CONIGLIO, Andrea S. HARTMANN, Anne E. BECKER, Kamryn T. EDDY, Jennifer J. THOMAS, 2017. Are eating disorders "all about control?" : The elusive psychopathology of nonfat phobic presentations. In: International Journal of Eating Disorders. Wiley-Blackwell. 2017, 50(11), pp. 1306-1312. ISSN 0276-3478. eISSN 1098-108X. Available under: doi: 10.1002/eat.22779
BibTex
@article{Murray2017eatin-55365,
  year={2017},
  doi={10.1002/eat.22779},
  title={Are eating disorders "all about control?" : The elusive psychopathology of nonfat phobic presentations},
  number={11},
  volume={50},
  issn={0276-3478},
  journal={International Journal of Eating Disorders},
  pages={1306--1312},
  author={Murray, Helen B. and Coniglio, Kathryn and Hartmann, Andrea S. and Becker, Anne E. and Eddy, Kamryn T. and Thomas, Jennifer J.}
}
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    <dcterms:abstract xml:lang="eng">Objective:&lt;br /&gt;There are a subset of individuals with eating disorders (EDs) who do not overevaluate body shape/weight (i.e., nonfat phobic ED; NFP-ED). According to the transdiagnostic cognitive–behavioral conceptualization of EDs, a need for control, in general, is hypothesized as the core psychopathology of NFP-EDs, with shape- and weight-related motivations for ED behavior merely superimposed in FP-ED presentations. This study tested the need for control as motivation for restriction in NFP-ED, using items aimed at assessing control from the Eating Disorder Examination (EDE) Restraint scale.&lt;br /&gt;&lt;br /&gt;Method:&lt;br /&gt;Females ages 13–27 years consecutively admitted to residential treatment completed the EDE, Eating Disorder Inventory-3 Drive for Thinness subscale (EDI-DFT), and other self-report measures of psychopathology. We included patients with DSM-5 EDs, but excluded patients with avoidant/restrictive food intake disorder. Twenty participants had NFP-ED (≤14 on EDI-DFT) and 124 had fatphobic ED (FP-ED; &gt;14 on EDI-DFT).&lt;br /&gt;&lt;br /&gt;Results:&lt;br /&gt;NFP-ED scored significantly lower than FP-ED on EDE Restraint scale shape/weight [χ2(1) = 10.73–35.62, p's &lt; .01] and on control items [χ2(1) = 10.72–20.62, p's &lt; .01], in addition to scoring lower on measures of general psychopathology and impairment.&lt;br /&gt;&lt;br /&gt;Discussion:&lt;br /&gt;Findings suggest those with NFP-ED report lower psychopathology overall and the new EDE Restraint scale control items do not capture additional motivation for restriction beyond that captured in the original Restraint scale shape/weight items. Future research should examine whether this latter finding is due to a minimizing response style in NFP-ED, an incomplete capture of desire for control by the EDE assessment method, or indeed reflects that need for control does not motivate restriction in NFP-EDs.</dcterms:abstract>
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