Objective: Many individuals with an eating disorder do not receive appropriate care. Low-threshold interventions could help bridge this treatment gap. The study aim was to evaluate the... Show moreObjective: Many individuals with an eating disorder do not receive appropriate care. Low-threshold interventions could help bridge this treatment gap. The study aim was to evaluate the effectiveness of Featback, a fully automated online self-help intervention, online expert-patient support and their combination.Method: A randomized controlled trial with a 12-month follow-up period was conducted. Participants aged 16 or older with at least mild eating disorder symptoms were randomized to four conditions: (1) Featback, a fully automated online selfhelp intervention, (2) chat or email support from a recovered expert patient, (3) Featback with expert-patient support and (4) a waiting list control condition. The intervention period was 8 weeks and there was a total of six online assessments. The main outcome constituted reduction of eating disorder symptoms over time. Results: Three hundred fifty five participants, of whom 43% had never received eating disorder treatment, were randomized. The three active interventions were superior to a waitlist in reducing eating disorder symptoms (d = -0.38), with no significant difference in effectiveness between the three interventions. Participants in conditions with expert-patient support were more satisfied with the intervention. Discussion: Internet-based self-help, expert-patient support and their combination were effective in reducing eating disorder symptoms compared to a waiting list control condition. Guidance improved satisfaction with the internet intervention but not its effectiveness. Low-threshold interventions such as Featback and expert-patient support can reduce eating disorder symptoms and reach the large group of underserved individuals, complementing existing forms of eating disorder treatment. Public significance statement: Individuals with eating-related problems who received (1) a fully automated internet-based intervention, (2) chat and e-mail support by a recovered individual or (3) their combination, experienced stronger reductions in eating disorder symptoms than those who received (4) usual care. Such brief and easyaccess interventions play an important role in reaching individuals who are currently not reached by other forms of treatment. Show less
The results described in this thesis support the strong empirical evidence for the effectiveness of CBT-Ef for patients with an eating disorder and a BMI>17.5. When compared to TAU, we found... Show moreThe results described in this thesis support the strong empirical evidence for the effectiveness of CBT-Ef for patients with an eating disorder and a BMI>17.5. When compared to TAU, we found comparable effects on eating disorder psychopathology, however CBT-Ef is superior in enhancing self-esteem with significantly fewer sessions and within a shorter time. We found no support for the hypothesis that more severe self-esteem problems, higher levels of perfectionism, or more interpersonal problems would obstruct long-term improvement and would therefore need extra attention in an extended protocol. A broader use of CBT-Ef in clinical practice could result in more efficient and accessible treatment for patients with an eating disorder. In another study we found COMET to be effective in enhancing self-esteem in patients with an eating disorder. Since we did not find the predictive value of low self-esteem in CBT-E treatment outcome, we suggest to integrate COMET in an eating disorder treatment only when low self-esteem is pronounced and interferes with making progress. Show less
Yellowlees, R.; Dingemans, A.E.; Veldhuis, J.; Bij de Vaate, A.J.D. 2019
IntroductionWith the rise of camera phones, selfie-taking has become a normative part of our modern culture. However, little is known about how this behavior may relate to eating disorder (ED)... Show moreIntroductionWith the rise of camera phones, selfie-taking has become a normative part of our modern culture. However, little is known about how this behavior may relate to eating disorder (ED) characteristics, particularly in those who already have eating disorder symptoms of clinical severity. The current study investigated how selfie-posting and selfie-taking with no intention of posting online (offline selfies) were related to ED symptoms.MethodA total of 152 females (average age 22.44 years) with ED symptoms of clinical severity completed self-report questionnaires measuring selfie-frequency (online and offline), frequency of non-selfie photo posting, social networking site use, body dissatisfaction, body checking, ED symptom severity, self-esteem and body avoidance. Responses were collected via an ED social community.ResultsNo direct relationship, or indirect association via body dissatisfaction, was found between selfie behavior and ED symptom severity. However, the more offline selfies an individual took, the more frequently they body checked, and this, in turn, was related to greater ED symptom severity.ConclusionsThese results suggest that offline selfies may be a modern form of body checking. Our findings are the first to imply that offline selfie-taking may be a problematic behavior and a potential maintenance factor for individuals with severe ED symptoms. Show less
Aardoom, J.J.; Dingemans, A.E.; Landt, M.C.T.S.O.; Furth, E.F. van 2012
The first aim of this study was to provide norms for the Eating Disorder Examination Questionnaire (EDE-Q) in a diverse and large clinical sample of individuals with an eating disorder (ED), and a... Show moreThe first aim of this study was to provide norms for the Eating Disorder Examination Questionnaire (EDE-Q) in a diverse and large clinical sample of individuals with an eating disorder (ED), and a general population sample without an ED. Norms for individuals with obesity without an ED were also provided, as a more relevant comparison group for individuals with binge eating disorder. The second aim was to investigate the discriminative validity of the EDE-Q. A sample of females with an ED (N=935), women from the general population without an ED (N=235), and obese females without an ED (N=321) completed the EDE-Q Explorative factor analyses did not support the theorized four subscales of the EDE-Q. Norms for EDE-Q global scores were provided for each of the three samples. Within the ED sample, norms were provided separately for patients with different ED diagnoses. Receiver operating characteristic analyses showed the EDE-Q global score to be highly accurate in discriminating individuals with an ED from those without, and moderately accurate in discriminating individuals with binge eating disorder from those with obesity. The presented norms contribute to a more accurate interpretation of EDE-Q scores, providing an index of the severity level of ED psychopathology. Furthermore, these norms can be used to assess clinical significant change during treatment. In addition, this study demonstrates that the EDE-Q when using its global score, is a valid instrument to assess levels of ED psychopathology. (C) 2012 Elsevier Ltd. All rights reserved. Show less
In this thesis, a series of studies on different aspects of the genetics of eating disorders is presented. The heritability of disordered eating behavior and attitudes in relation with body mass... Show moreIn this thesis, a series of studies on different aspects of the genetics of eating disorders is presented. The heritability of disordered eating behavior and attitudes in relation with body mass index (BMI) was evaluated in a large adolescent twin-family sample ascertained through the Netherlands Twin Registry. Furthermore, the association of four candidate genes with anorexia nervosa and eating disorders characterized by self-induced vomiting was tested in a female patient group from the Genetics of Eating Disorder (GenED) study and a female control group from the Netherlands Twin Registry. Subsequently the observed association between the Tryptophan Hydroxylase 2 (TPH2) gene and eating disorders was investigated further. In a group of random controls and a group of patients with an eating disorder it was evaluated if the TPH2 gene was also associated with two potential risk factors for eating disorders: perfectionism and impulsivity. The results shed more light on the relationship between these factors and eating disorders. Show less
