Introduction Introduction: eating disorders (ED) such as anorexia nervosa (AN) or bulimia nervosa (BN), as well as obesity (OB), are related to emotional and neuropsychological impairments on measures of cognitive flexibility, central coherence or decision making. However, little is known about the association among emotional regulation, neuropsychological variables and affect. Objectives: to analyze whether neuropsychological and affect variables can predict emotional regulation in ED and in OB. Methods: thirty females with restricting ED (restricting AN) were assessed, 18 with purging ED (purging AN and BN), 33 with OB and 39 healthy controls matched for intelligence. The Wisconsin Card S…

Intrusive Thoughts in Obsessive-Compulsive Disorder and Eating Disorder Patients: A Differential Analysis

The present study aims to compare the unwanted intrusions experienced by obsessive–compulsive (OCD) and eating disorder (ED) patients, their appraisals, and their control strategies and analyse which variables predict the intrusions' disruption and emotional disturbance in each group. Seventy-nine OCD and 177 ED patients completed two equivalent self-reports designed to assess OCD-related and ED-related intrusions, their dysfunctional appraisals, and associated control strategies. OCD and ED patients experienced intrusions with comparable frequency and emotional disturbance, but OCD patients experienced greater disruption. Differences appeared between groups on some appraisals and control s…

The Role of Negative Affect in Emotional Processing of Food-Related Images in Eating Disorders and Obesity

The aim of the present study was to analyze differences in the emotional processing (valence, arousal, and dominance) of food-related information in patients with eating disorders (ED), patients with obesity, and healthy women. Moreover, the mediator role of negative affect and the moderating role of the diagnostic group (ED vs. non-ED) were analyzed. Method: The sample consisted of 94 women (39 with eating disorders, 19 with obesity, and 36 healthy participants). Measures: International Affective Picture System (IAPS) food picture exposure task; Self-Assessment Manikin Analog-Visual Scale (SAM) appraising Arousal, Valence, and Dominance; Eating Attitudes Test (EAT-26); Positive and Negativ…

Virtual reality treatment of flying phobia.

Flying phobia (FP) might become a very incapacitating and disturbing problem in a person's social, working, and private areas. Psychological interventions based on exposure therapy have proved to be effective, but given the particular nature of this disorder they bear important limitations. Exposure therapy for FP might be excessively costly in terms of time, money, and efforts. Virtual reality (VR) overcomes these difficulties as different significant environments might be created, where the patient can interact with what he or she fears while in a totally safe and protected environment, the therapist's consulting room. This paper intends, on one hand, to show the different scenarios desig…

Confirmatory factor analysis and psychometric properties of the Yale–Brown–Cornell Eating Disorders Scale Self-Report version (SR-YBC-EDS) in Spanish clinical and non-clinical samples

[EN] Objective: The aimof the study was to adapt and validate the Yale Brown Cornell Eating Disorder Scale (YBC-EDS) transformed into a self-report format in Spanish clinical and non-clinical samples. Method: Eighty-three eating disordered patients and 358 non-clinical participants completed the Self Report-YBCEDS version (SR-YBC-EDS), the Eating Attitudes Test (EAT), and the Penn State Worry Questionnaire (PSWQ). Results: Confirmatory factor analyses of a two-factor second-order model showed adequate values of goodness-of fit indices for non-clinical (normed ÷2=13.4578; df=18; NFI=0.980; GFI=1.00; RMSEA= 0.00) and clinical samples (normed ÷2 = 26.5913; df =18; NFI = 0.944; GFI = 0.981; RMS…

Contribution of executive functions to eating behaviours in obesity and eating disorders.

AbstractBackground:Patients with eating disorders (ED) or obesity show difficulties in tasks assessing decision-making, set-shifting abilities and central coherence.Aims:The aim of this study was to explore executive functions in eating and weight-related problems, ranging from restricting types of ED to obesity.Method:Two hundred and eighty-eight female participants (75 with obesity; 149 with ED: 76 with restrictive eating, 73 with bingeing-purging symptoms; and 64 healthy controls) were administered the Wisconsin Card Sorting Test, the Iowa Gambling Task, and the Group Embedded Figures Test to assess set-shifting, decision-making and central coherence, respectively.Results:Participants wi…

Clinical validation of a virtual environment for normalizing eating patterns in eating disorders

The purpose of the present study was to examine the clinical validation of a Virtual Reality Environment (VRE) designed to normalize eating patterns in Eating Disorders (ED). The efficacy of VR in eliciting emotions, sense of presence and reality of the VRE were explored in 22 ED patients and 37 healthy eating individuals. The VRE (non-immersive) consisted of a kitchen room where participants had to eat a virtual pizza. In order to assess the sense of presence and reality produced by the VRE, participants answered seven questions with a Likert scale (0-10) during the experience, and then filled out the Reality Judgment and Presence Questionnaire (RJPQ) and ITC-Sense of Presence Inventory (I…

Psychometric properties of the Situational Inventory of Body-Image Dysphoria-Short form in a Spanish sample

The primary objective of this study was to translate and validate Situational Inventory of Body-Image Dysphoria-Short form (SIBID-S) in a Spanish population. The scale consists of 20 items to assess the frequency of dysphoric body-image emotions in certain situational contexts, using a five-point rating scale. The questionnaire was administered to 214 women between the ages of 14 and 29 years, from primary and secondary schools and a university. Principal components analysis indicated a one-factor structure for the entire sample and both younger (18) and older (or=18) participants. Internal consistency was high (0.94), and the test-retest reliability over 1 month ranged between 0.89 and 0.9…

Ego-syntonicity and ego-dystonicity of eating-related intrusive thoughts in patients with eating disorders.

Abstract The main objective of the present study was to analyse the role of the ego-dystonicity and ego-syntonicity of eating disorder intrusive thoughts (EDITs) in the genesis and maintenance of eating disorders (EDs). Participants were 98 female patients with EDs, 56 Spanish and 42 English (27.19±9.59 years; body mass index (BMI): 18.72±2.87). All of them completed the eating attitudes test, the Eating Attitudes Test, the Eating Intrusive Thoughts Inventory, the Ego-Dystonicity Questionnaire-Reduced version, and the Ego-Syntonicity Questionnaire. Patients indicated that their EDITs were rational and also undesirable and immoral, suggesting that EDITs are not fully ego-syntonic or ego-dyst…

Virtual reality treatment of claustrophobia: a case report.

The efficacy of a treatment for claustrophobia using only Virtual Reality (VR) exposure was examined. The subject was a 43-year-old female who suffered from clinically significant distress and impairment and sought psychological therapy. Eight individual VR graded exposure sessions were conducted. All self-report measures were reduced following VR exposure and were maintained at one month follow-up. The necessity of a theoretical framework for this new medium for exposure therapy is discussed.

Eating-related Environmental Factors in Underweight Eating Disorders and Obesity: Are There Common Vulnerabilities During Childhood and Early Adolescence?

Objective This study aimed to examine whether there is an association between individual, social and family influences and dysfunctional eating patterns early in life and the likelihood of developing a subsequent underweight eating disorder (ED) or obesity. Method The total sample comprised 152 individuals (underweight ED, n = 45; obese patients, n = 65; healthy controls; n = 42) from Barcelona, Spain. The Cross-Cultural Questionnaire (CCQ) was used to assess early eating influences as well as individual and family eating patterns and attitudes towards food. Results Even though a few shared eating influences emerged for both groups, unique factors were also observed. Whereas relationship wi…

Selective Processing of Food– and Body–Related Information and Autonomic Arousal in Patients with Eating Disorders

Both attentional bias (using the modified Stroop Task) and autonomic reactivity (skin conductance level) to food- and body-related information were assessed in 25 patients with eating disorders (15 patients with anorexia, 10 patients with bulimia) and 18 women controls. Patients with anorexia showed the greatest interference in color-naming food-related words. However, on this occasion there were no differences in body condition, probably because of heterogeneity of clinical samples and because the control group were staff members, so the target information was very familiar to them. The groups differed in their autonomic reactivity while performing the Stroop, the patients with anorexia re…

Self-consciousness Scale: a study of Spanish housewives.

The purpose of this study was to examine the applicability with 93 Spanish housewives of the translated Self-consciousness Scale. We present reliability measures and normative data, and we also include data for two clinical samples (31 depressive and 31 asthmatic women patients).

Psychological Variables and Reality Judgment in Virtual Environments: The Roles of Absorption and Dissociation

Literature on virtual reality (VR) and psychology has focused on the influence that some basic psychological processes have on VR. Although psychological processes may be defined as common to all humans, there are individual differences that might make it difficult to provide the same VR experience for everyone. Of the several personality and psychological variables that might be relevant to the VR field, this study focuses on two: absorption and dissociation. Both psychological dimensions are deeply interrelated and might play an important role in the immersion of subjects in virtual environments and in the reality attributions they make. Thus, the purpose of this study was to ascertain pe…

Eating-related Intrusive Thoughts Inventory: exploring the dimensionality of eating disorder symptoms.

The aims of this study were, first, to examine the structure and validity of the Eating-related Intrusive Thoughts Inventory (INPIAS), a self-report questionnaire designed to assess eating disorders related to intrusive thoughts (EDITs), and second, to explore the existence of a continuum ranging from normal to abnormal thought intrusions related to eating, weight, and shape. Participants were 574 (408 women) nonclinical community individuals. Analyses revealed that EDITs can be clustered into three sets: appearance-dieting, need to exercise, and thoughts-impulses related to eating disorders. EDITs' consequences showed a two-factor structure: emotional consequences/personal meaning and tho…

Schizophrenia and automatic processing: an exploratory study.

This study deals with the schizophrenic deficit as one of automatic processing. To test the idea, a special experimental task was designed on which 21 schizophrenics, 21 depressives, and 21 normal subjects had to complete a series of simple geometric figures. When the subjects had thoroughly learned this activity, another information source, a brief story, was introduced, and the subjects had to pay attention to the story while they did the task. Two dependent variables were considered, execution time and performance. There were no differences among the three groups in the first experimental condition; but in the second condition, when the distractor was introduced, schizophrenics needed m…

Similarities and differences between eating disorders and obese patients in a virtual environment for normalizing eating patterns.

Virtual reality has demonstrated promising results in the treatment of eating disorders (ED); however, few studies have examined its usefulness in treating obesity. The aim of this study was to compare ED and obese patients on their reality judgment of a virtual environment (VE) designed to normalize their eating pattern. A second objective was to study which variables predicted the reality of the experience of eating a virtual forbidden-fattening food. ED patients, obese patients, and a non-clinical group (N = 62) experienced a non-immersive VE, and then completed reality judgment and presence measures. All participants rated the VE with similar scores for quality, interaction, engagement,…

The treatment of the body image disturbances in eating disorders and clinically significant change

Body image disturbance is a significant maintenance and prog-nosis factor in eating disorders. Hence, existing eating disorder treatments can benefit from direct intervention in patients’ body image. This paper in-cludes a controlled study comparing cognitive behavioural treatment for eating disorders with and without a component for body image treatment using virtual reality techniques. The objective of this work was to check if both types of treatment produced a change clinically significant at the end of the treatment and the follow-up to the year, in body image, eating disor-ders and general psychopathology. Thirty-four participants diagnosed with eating disorders were treated and compa…

The Use of a Nonimmersive Virtual Reality Programme in Anorexia Nervosa: A Single Case-Report

Objective: People with anorexia nervosa (AN) experience high levels of fear and anxiety related to eating. The aim of this case report was to describe the use of a virtual reality (VR) programme developed to facilitate exposure to food as a supplement to treatment for a person with AN. Method: A 21-year-old patient with AN was given the VR module in addition to the Maudsley Model of Treatment for Adults with Anorexia Nervosa. Weight, eating disorder symptomatology (EDE-Q) and general psychopathology (DASS) were assessed before and after the module was delivered. Results: At the end of the module, the patient reported lower levels of anxiety, safety behaviours and fears related to food. Both…

Is the selective information processing of food and body words specific to patients with eating disorders?

The selective processing of food- and body size-related information was investigated using a modified version of the Stroop task. Anorexic and bulimic patients and matched female controls were compared on the basis of categorical (diagnosis), dimensional (restraint and drive for thinness) criteria, or both. The findings suggest that the phenomenon assessed by the Stroop paradigm is not exclusive to patients with a clinical eating disorder, but patients and those control subjects who are restrained eaters with a high drive for thinness share a selective processing of information related to shape and eating. The discussion focuses on the implications of these findings. © 1993 by lohn Wiley & …

Janet D. Latner and G. Terence Wilson (Eds.) (2007).Self-help approaches for obesity and eating disorders. Research and practice. The Guilford Press: New York, USA, pp. 376, ISBN-13: 978-1-59385-442-3

Clinical utility of cognitive-behavioural treatment for panic disorder. results obtained in different settings: a research centre and a public mental health care unit

Cognitive-Behavioural programmes have become the treatment of choice for Panic Disorder (PD). However, although its effectiveness has been widely demonstrated, there are still some limitations regarding the possibility of offering this type of treatment to all panic sufferers. Some researchers are studying ways to make these programmes more available. This study deals with the application and testing of treatment programmes for PD in sites where patients usually look for help for their psychological problems, i.e. mental health care centres. Our work follows a strategy of benchmarking, and the results obtained after applying the treatment in habitual clinical contexts are compared with the …

Virtual reality in eating disorders

Virtual Reality (VR) is widely used as a therapeutic tool in the field of neuropsychology and also in the treatment of anxiety disorders. In contrast, VR is much less well-known in the area of the eating disorders. The objective of this paper is to draw attention to possible applications of this technology in the treatment of eating disorders and describe pilot work in the area of body image disturbance and binge eating using VR technology. Copyright © 2003 John Wiley & Sons, Ltd and Eating Disorders Association.

Normalizing the eating pattern with virtual reality for bulimia nervosa: a case report

AbstractThe aim of the present study was to analyze the effects of a virtual reality (VR) component as a therapeutic tool to normalize eating patterns, as part of the cognitive-behavioral treatment of a bulimia nervosa (BN) patient. Results indicated that the patient made significant progress with her eating habits; binges and vomits were eliminated completely. Moreover, when the VR started the patient avoided food, especially meat (5 over 5), and it was reduction of this avoidance in the lasts sessions (2 and 3 over 5). It was also observed a reduction in the avoidance and the fear of eating (from 10 and 9 to 6 and 5 respectively) and increased the impulse control (from 2 to 7). The patien…

Entrenamiento en remediación cognitiva y habilidades emocionales en formato grupal para pacientes con obesidad: un estudio piloto

Abstract: Group cognitive remediation and emotion skills training for patients with obesity. A pilot study. Cognitive remediation and emotion skills training was initially designed by the Tchanturia group for individual intervention in patients with eating disorders. The purpose of the present study is to present its adaptation to patients with obesity in group format. It is structured in 8 weekly sessions that work on central executive functions, the relation between emotion and thought, and emotion regulation in oneself and others. In addition, we present the preliminary results of its application to a group of 5 participants with morbid obesity to assess its possible efficacy. The result…

Study of Obsessive Compulsive Beliefs: Relationship with Eating Disorders

Background: The relationship between Eating Disorders (ED) and Obsessive Compulsive Disorder (OCD) has been extensively studied in the last few years. However, little effort has been devoted to studying the link between these disorders with regard to their distorted beliefs. Aims: The first objective of the study was to analyze the differences in OCD-related beliefs among ED subtypes and the general population, controlling for age, Body Mass Index, and obsessionality. The second objective was to explore which OCD beliefs explain ED symptomatology. Method: Seventy-nine ED patients without OCD comorbidity, divided into diagnostic subtypes, and 50 community participants completed the Obsessive…

Emotional eating scale for children and adolescents: psychometric characteristics in a Spanish sample

The aims of this study were to validate the Emotional Eating Scale version for children (EES-C) in a Spanish population and study the differences in emotional eating among children with binge eating (BE), overeating (OE), and no episodes of disordered eating (NED). The questionnaire was completed by 199 children aged 9 to 16 years. Confirmatory factor analysis revealed five scales: eating in response to anger, anxiety, restlessness, helplessness, and depression. The EES-C showed good internal consistency and test-retest reliability, and it showed moderate relationships with measures of disordered-eating [Children's Eating Attitudes Test-26 (ChEAT-26), Questionnaire of Eating and Weight Patt…

Analysis of the Effectiveness of Cognitive Remediation and Emotional Skills Training in a Group format. Preliminary results in patients with eating disorders

Eating disorders (ED) are associated with cognitive and emotional impairments. Cognitive and Emotional Remediation Skill Training (CREST) was developed as an intervention program targeting patients' thinking styles and their skills in recognizing and managing emotions. AIM: to analyze the effects of the CREST intervention in a group format in females with ED. METHOD: eight females underwent a CREST program (eight 90-minute sessions) targeting cognitive (central coherence, set shifting, problem solving) and emotional (recognizing emotions, managing emotions) difficulties. It was assessed cognitive flexibility (Wisconsin Card Sorting Test), decision-making (Iowa Gambling Task), central cohere…

Body Image and Virtual Reality in Eating Disorders: Is Exposure to Virtual Reality More Effective than the Classical Body Image Treatment?

Body image (BI) disturbances are considered to be central in eating disorders (ED) psychopathology. There are few studies focused on the treatment of BI disturbances in ED, and most of them have used "traditional methods." The purpose of the present study was to probe the effectiveness of one specific component in the assessment and treatment of BI in ED by means of virtual reality (VR). Two treatment conditions were applied: (a) The Standard Body Image Treatment Condition (SBIT) and (b) the VR Condition. Thirteen eating disordered patients were randomly assigned to one of those conditions. No differences between both conditions were found in general ED measures, but patients treated in the…

La evaluación del perfeccionismo: utilidad de la Escala Multidimensional de Perfeccionismo en población española

La Escala Multidimensional de Perfeccionismo (MPS) de Frost et al. (1990) es uno de los instrumentos con más tradición empírica y mayor influencia en el estudio del perfeccionismo. El objetivo de este trabajo es traducir y validar la MPS para su uso en población española. Para ello, 434 participantes (77% mujeres; edad media: 23,38 años), completaron la versión española de la MPS junto con cuestionarios de obsesividad, trastornos alimentarios, y preocupaciones ansiosas, para evaluar la validez convergente de la MPS. El análisis de componentes principales (varianza explicada: 56%), reveló una estructura de 4 factores en lugar de los 6 originales: Miedo a los errores, Influencias paternas, Ex…

Body image and adolescence: A behavioral impairment model.

Adolescence is a period marked by important physical and social changes that can lead to a negative body image. The purpose of this study was to find a model enabling the appearance of behavioral impairment related to body image (restrictions, avoidance, and checking) to be predicted by body image attitudes (concern or Appearance Orientation, and dissatisfaction or Appearance Evaluation), Gender, emotional symptomatology, self-consciousness, ideas of reference (IR) and age. A total of 661 participants (67.47% girls) with an average age of 17.14 years (SD=2.34) filled in the GHQ-28, SCS on self-consciousness, REF referential thinking scale, MBSRQ (AO and AE), and BIAQ. A partial mediation mo…

Obsessional and Eating Disorder-related Intrusive Thoughts: Differences and Similarities Within and Between Individuals Vulnerable to OCD or to EDs

Unwanted intrusive cognitions constitute the normal variant of clinically significant intrusive cognitions found in disorders such as obsessive-compulsive disorder (OCD) and eating disorders (EDs). This study investigates whether individuals who are vulnerable to OCD or EDs experience more intrusions than people with no vulnerability to these disorders, and it examines the consequences of obsessional (OITs) and eating disorder (EDITs) intrusions in the same individuals, taking into account their susceptibility to OCD, EDs or neither of the two. From a sample of 922 participants, three groups were formed: risk of OCD (n = 92), risk of EDs (n = 41) and a no-risk group (n = 100). EDITs were mo…

The VEPSY UPDATED Project: Clinical Rationale and Technical Approach.

More than 10 years ago, Tart (1990) described virtual reality (VR) as a technological model of consciousness offering intriguing possibilities for developing diagnostic, inductive, psychotherapeutic, and training techniques that can extend and supplement current ones. To exploit and understand this potential is the overall goal of the "Telemedicine and Portable Virtual Environment in Clinical Psychology"--VEPSY UPDATED--a European Community-funded research project (IST-2000-25323, www.cybertherapy.info). Particularly, its specific goal is the development of different PC-based virtual reality modules to be used in clinical assessment and treatment of social phobia, panic disorders, male sexu…

¿TIENEN LOS NIÑOS PENSAMIENTOS INTRUSOS ANÁLOGOS A OBSESIONES? PRESENTACiÓN DE UN INSTRUMENTO ESTANDARIZADO Y RESULTADOS PRELIMINARES

Los pensamientos intrusos no deseados con contenidos similares a las obsesiones clínicas, constituyen una experiencia prácticamente universal en adultos sin psicopatologías. Sin embargo, no existen apenas evidencias de la presencia de estas introsiones en población infantil y pre-adolescente. En este trabajo se presenta el Inventario de Pensamientos Intrusos Obsesivos para Nif'los y Adolescentes (INPIOS-NA), que recoge en 45 items la frecuencia con que se experimentan intrusiones con temática obsesivo-compulsiva. Lo completaron 122 nif'los (12 y 13 af'los). El análisis factorial exploratorio produjo cuatro factores: 1) Agresión, sexo, acumulación; 2) Contaminación y dudas; 3) Superstición y…

Virtual reality in the treatment of claustrophobic fear: A controlled, multiple-baseline design

The aim of this study was to determine the effectiveness of virtual reality (VR) exposure in the treatment of claustrophobic fear. We evaluated the intervention following a controlled, multiple-baseline design across 4 participants with claustrophobic fear who sought psychological help in our anxiety disorders clinic. The treatment consisted of 8 individual VR graded exposure sessions. Data were obtained at pretreatment, posttreatment, and 3-month follow-up on several clinical measures: Behavioral Avoidance Test, Self-Efficacy Toward Closed Spaces, Problem-Related Impairment Questionnaire, Beck Depression Inventory (Beck, 1978), and Anxiety Sensitivity Index (Peterson & Reiss, 1992). Result…

Effectiveness of cognitive behavioral therapy supported by virtual reality in the treatment of body image in eating disorders: One year follow-up

Body image disturbance is a significant maintenance and prognosis factor in eating disorders. Hence, existing eating disorder treatments can benefit from direct intervention in patients' body image. No controlled studies have yet compared eating disorder treatments with and without a treatment component centered on body image. This paper includes a controlled study comparing Cognitive Behavioral Treatment (CBT) for eating disorders with and without a component for body image treatment using Virtual Reality techniques. Thirty-four participants diagnosed with eating disorders were evaluated and treated. The clinical improvement was analyzed from statistical and clinical points of view. Result…

Measuring Orthorexia Nervosa: Psychometric Limitations of the ORTO-15.

AbstractOrthorexia nervosa has recently been defined as excessive preoccupation with healthy eating, causing significant nutritional deficiencies and social and personal impairments. The ORTO-15 is the most widely used instrument to evaluate orthorexia nervosa, although previous studies obtained inconsistent results about its psychometric properties, and there are no data on the Spanish version. Thus, the main objective of the present study was to analyze the psychometric properties of the Spanish adaptation of the ORTO-15. In order to cross-validate the results, two independent samples were used (Sample 1: n = 807, 74.1% women; Sample 2: n = 242, 63.2% women). The results did not support t…

Confirmatory factor analysis and psychometric properties of the Spanish version of the Multidimensional Body-Self Relations Questionnaire-Appearance Scales in early adolescents

The main aim of this study was to confirm the factorial structure of the Spanish version of the Multidimensional Body-Self Relations Questionnaire-Appearance Scales in early adolescents from 12 to 14 years. The sample included 355 participants, 189 girls and 166 boys, with ages ranging from 12 to 14 years old. The original MBSRQ-AS 5-factor structure was confirmed, and the model showed a good fit to the data: Appearance Evaluation, Appearance Orientation, Body Areas Satisfaction, Overweight Preoccupation, and Self-Classified Weight. The internal consistency of the test scores was adequate. Girls had higher score s than boys on Appearance Orientation, Overweight Preoccupation, and Self-Class…