Assessing Diagnostic Overshadowing For Co-Occurring Autism Spectrum Disorder (Asd) And Eating Disorders (Ed), Eden Sweet

Scripps Senior Theses

Significant behavioral overlaps in feeding patterns are observed among individuals with eating disorders (EDs) and autism spectrum disorder (ASD). These behavioral similarities can blur diagnostic boundaries, contribute to diagnostic overshadowing, and consequently increase the risk of misdiagnosis and the implementation of ineffective treatment approaches. The proposed study addresses the risk of diagnostic overshadowing as it relates to the ambiguous distinction between autism-driven feeding behaviors and clinically significant eating disorders (ED) within the autistic population. Although the literature has acknowledged behavioral similarities between ASD and EDs, limited research has systematically examined how they impact diagnostic practices and influence the likelihood of …

Moderators Of Subjective Distress And State Body Image During Open And Blind Weighing, Danielle E. Peters

Electronic Theses & Dissertations (2024 - present)

Objective: Body image disturbances are central to eating disorder (ED) pathology and are often addressed through exposure-based methods, such as open weighing. Open weighing is recommended in evidence-based ED treatments, but many clinicians and patients prefer blind weighing. It may be that pre-treatment patient characteristics may influence how distressed they feel by open and blind weighing. As such, the present study aimed to 1) compare how open and blind weighing impact subjective distress and state body image, and 2) examine whether self-weighing tendencies, body avoidance, body checking, body checking-related beliefs, intolerance of uncertainty, and ED psychopathology moderate the relationship between …

Weighing The Costs: Understanding How Eating Disorder History And Motivation For Use Impacts Experience On A Glucagon-Like Peptide-1 Receptor Agonist And Interest In Future Use, Kimberly M. Gauert

Electronic Theses & Dissertations (2024 - present)

Glucagon-Like Peptide-1 receptor agonist (GLP-1 RA) medications have become popular tools due to their effectiveness regarding weight loss and chronic disease management. The drastic increase in demand for these medications has led to widespread availability and an increase in “off-label” use for cosmetic purposes. Although GLP-1 RA medications have the potential to positively impact overall health and wellbeing, there is also concern regarding potential misuse of these medications by those with a history of eating disorder behaviors. However, few studies to date have examined the relationship between a history of eating disorder pathology, reason for GLP-1 RA use, and current …

The Relationship Between Interoceptive Awareness And Eating Disorder Symptomatology, Madelyn G. Johnson

Electronic Theses & Dissertations (2024 - present)

Interoceptive awareness (IA; e.g., the ability to perceive and interpret internal bodily sensations) is increasingly recognized as central to eating disorder (ED) psychopathology, yet findings remain mixed regarding whether heightened IA is protective or maladaptive. Across two studies using a sample of 654 college students (Mage = 18.74, SD = 1.56; 46% White; 58% female) from a large northeastern U.S. university, we examined (1) how specific IA facets relate to ED symptom severity, and (2) whether anxiety sensitivity (AS) helps explain these associations. In Study 1, linear regressions predicting Eating Disorder Examination Questionnaire–7 (EDE-Q7) scores showed that nearly all MAIA-2 …

Proposed Theoretical Model Of Pediatric Onset Multiple Sclerosis And Restrictive Eating Behaviors, Anna L. Smith

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Multiple Sclerosis (MS), a chronic, demyelinating, autoimmune disease that causes an array of physical and cognitive symptomatology, is commonly diagnosed in adulthood. Pediatric Onset Multiple Sclerosis (POMS) is characterized by diagnosis of the disease before age 18 and accounts for about 5% of MS cases. While there is a growing body of literature examining the impact of adult-onset multiple sclerosis on psychosocial functioning, research specifically addressing POMS remains limited. Moreover, there is a notable gap in the literature regarding the risk of eating disorders among individuals with POMS. This paper will explore a constellation of potential risk factors that may …

An Adaptive Paradox: Improvised Drama Therapy And Dialectical Behavior For Eating Disorders In Teens, Krystany Taylor

Expressive Therapies Theses

The complexity of treating eating disorders compels professionals to investigate collaborative and integrative approaches to address psychological rigidity and emotional aversion in affected individuals. Mindfulness within Dialectical Behavior Therapy (DBT) and improvisational theater techniques may contribute to advancing emotional flexibility. This thesis study explored spontaneity in expressive therapy and gauged budding adaptive skills related to emotion regulation in minors with eating disorders. At a behavioral health center in Southern California, I held a dual role as a group facilitator and trainee drama therapist; I therein joined DBT and improvised drama therapy methods into a group treatment setting for ages 14 …

Describing And Understanding The Use Of Coaches For Eating Disorder Recovery: A Mixed Methods Study, Taylor E. Penwell

Graduate Student Theses, Dissertations, & Professional Papers

Individuals with eating disorders (EDs) experience high rates of relapse and delays in accessing treatment. Considering these factors, individuals with EDs may seek out non-traditional support, such as coaching services (e.g., an unlicensed individual providing support). However, there is currently no research on individuals with EDs’ experiences with using coaching services for ED recovery. The current study aimed to a) describe who is utilizing coaching support, b) describe coaching services received, c) evaluate the motivations for seeking coach support, and d) evaluate the perceived impact of coach support on an individual’s ED recovery. Participants included 86 adults with a self-reported …

Development And Validation Of The Mealtime Behaviors Self-Report Questionnaire, Taylor Rae Perry

Electronic Theses & Dissertations (2024 - present)

Disturbances in eating are a hallmark feature of eating disorders (EDs). However, these disturbances extend beyond dietary patterns, as clinicians have long observed aberrant mealtime behaviors in individuals with EDs. Despite these observations, research on aberrant mealtime behaviors has been limited to a small case study of individuals with anorexia nervosa. Clinically, however, individuals across all ED diagnoses appear to exhibit these behaviors. Notably, there is currently no existing measure designed to assess aberrant mealtime behaviors. Developing such an assessment could provide clinicians with valuable information to inform mealtime interventions. Therefore, the present study aimed to examine the prevalence of …

Relational Mechanisms In Residential Eating Disorder Treatment: A Moderated Mediation Analysis, Bethany Ah Crawford

Electronic Theses & Dissertations (2024 - present)

Background. Eating Disorders (ED), previously described as a “disease of disconnection,” appear to have differing trajectories of treatment and behavior change based, in part, on feelings of connectedness to others during and outside of treatment. Patient experience of Relational Connectedness is not well-explored in ED treatment compared to other diagnoses but may be a valuable mechanism of change. Interpersonal problems are also known to impact outcome trajectories. Patients high in interpersonal and relational difficulties exhibit negative compensatory behaviors such as avoidance and hostility, which can deleteriously affect building a trusting relationship. Individual difference variables likely play a role in relationship-outcome …

The Relationship Between Religious Coping Styles And Eating Disorder Risk In Christians In A University Setting, Meghan E. Aubuchon

Honors Theses

Existing research on eating disorders and religion is beginning to gain momentum in the present day, but research is lacking on the topic of religious coping and eating disorder risk. This study aimed to investigate the relationship between two known styles of religious coping—positive and negative—and eating disorder risk in University of Mississippi students, faculty, and staff who identify as Christian. A survey consisting of basic demographic questions, the EAT-26, and the Brief RCOPE was distributed via emails sent by the office of IREP to students, faculty, and staff at the University of Mississippi. A total of 330 participants were …

Exploring The Relationship Between Digital Homework Adherence And Eating Disorder Symptoms, Melanie Mcdonough

The Cardinal Edge

Given the high mortality and relapse rates associated with anorexia nervosa, and the limited efficacy of existing treatments, especially those utilized (Peterson, et al., 2016), recent research has highlighted the potential of digital programs to address these barriers and enhance treatment engagement (Stewart, et al., 2021). Purpose: To investigate whether higher engagement throughout treatment is related to less eating disorder behaviors though a digital treatment program. Hypothesis: Participants with higher levels of engagement in treatment will report fewer eating disorder behaviors posttreatment. Methods: Participants (N = 10; Mage = 32.3, SD = 2.78) were diagnosed with active anorexia nervosa (50%), …

Exploring The Relationship Between Digital Homework Adherence And Eating Disorder Symptoms., Melanie D. Mcdonough

The Cardinal Edge

Given the high mortality and relapse rates associated with anorexia nervosa, and the limited efficacy of existing treatments, especially those utilized (Peterson, et al., 2016), recent research has highlighted the potential of digital programs to address these barriers and enhance treatment engagement (Stewart, et al., 2021). Purpose: To investigate whether higher engagement throughout treatment is related to less eating disorder behaviors though a digital treatment program. Hypothesis: Participants with higher levels of engagement in treatment will report fewer eating disorder behaviors posttreatment. Methods: Participants (N = 10; Mage = 32.3, SD = 2.78) were diagnosed with active anorexia nervosa (50%), …

Testing The Feasibility And Acceptability Of A Mindful Self-Compassion Group Workshop Among Individuals With Eating Disorders: A Pilot Study., Brenna Mary Williams

Electronic Theses and Dissertations

Background. Shame and self-criticism are mechanisms shown to influence eating disorders (EDs). Self-compassion has been theorized to target shame and self-criticism and is a protective factor against EDs. One intervention shown to increase self-compassion and reduce shame and self-criticism is the Mindful Self-Compassion program (MSC). However, MSC has yet to be tested among individuals with an ED diagnosis. The current study investigated the feasibility, acceptability, and preliminary outcomes of MSC delivered in a live, online format among individuals with an ED. Methods. Sixty-one participants completed baseline questionnaires measuring ED symptoms, trait self-compassion, self-criticism, and shame. Participants also answered questionnaires at …

Clarifying The Relationship Between Weight Suppression And Eating Psychopathology: The Role Of Fear Of Weight Gain And Intolerance Of Uncertainty, Danielle Elizabeth Peters

Legacy Theses & Dissertations (2009 - 2024)

Objective: Weight suppression (WS), the discrepancy between a person’s highest and current body weight, is largely associated with eating pathology in clinical and non-clinical samples. WS may put individuals in a biobehavioral bind: biological factors may drive the body toward weight regain, which in turn drives eating disorder (ED) behaviors in an attempt to prevent weight regain. However, few studies have examined psychological factors that may play a role in the biobehavioral bind of WS. As such, the present study aimed to (1) whether WS was associated with fear of weight gain (FOWG) and intolerance of uncertainty (IU) and (2) …

In And Through The Body: A Quantitative Exploration Of Embodiment In Eating Disorders, Lauren Zaniboni

PsyD Program in Clinical Psychology Doctoral Dissertations (New England)

The field of clinical psychology has long privileged cognitive and affective experience and information over that which is stored in, and communicated by, the body (Caldwell, 2018; Young, 2006). Despite the profound and complex web of interactions between mind and body in EDs, this subspecialty has been no exception. The need for improvements in eating disorder (ED) treatment outcomes is well documented and transtheoretically accepted. Current practice guidelines for the treatment of adult EDs recommend the utilization of cognitive, behavioral, and interpersonal strategies to target problematic thinking and deficits in emotion regulation that are thought to fuel ED behaviors (American …

Does Dbt-Informed Treatment Address Comorbid Symptoms Of Social Anxiety For Adolescent Eating Disorder Patients In A Day Program? Exploring Emotion Regulation As A Mechanism For Change, Megan Bisanzo

Theses and Dissertations

Eating disorders, such as Anorexia Nervosa (AN) and Bulimia Nervosa (BN), often begin in adolescence and can be extremely challenging to treat effectively (Dawson, 2018; Martin & Golden 2014; Robatto et al., 2024). Eating disorder behaviors such as acute caloric restriction, excessive exercise, binging and purging can cause dangerous medical complications, while comorbid psychological conditions can lead to suicidal ideation and self-harm behaviors (American Psychiatric Association, 2022; Dancyger & Fornari, 2005; Martin & Golden, 2014). Social anxiety is one such comorbid disorder that can be a barrier to patients fully engaging in treatment (Goodwin & Fitzgibbon, 2002; Smith, 2018). Deficits …

The Cultural Adaptation Of An Eating Disorders Assessment Tool For South Asian American Women, Neha J. Goel

Theses and Dissertations

South Asians (SAs) are less likely to be screened, referred, and treated for eating disorders (EDs), although they experience these serious health conditions at rates similar to those of their White counterparts. Available ED assessment tools do not adequately capture cultural nuances in the presentation of eating psychopathology in SAs. Thus, the current study culturally adapted the Eating Disorder Examination-Questionnaire (EDE-Q) to enhance its validity, applicability, and cultural relevance for SA women living in the US. During the cultural adaptation phase, the principal investigator consulted with participant experts (N=24) and research experts (n=4) to create the …

Body Image Development And Eating Disorder Risk In Young Children: What Do Parents Want To Know?, Anna Atchison

Electronic Theses & Dissertations (2024 - present)

Background: Body image concerns and other risk factors for disordered eating can emerge in early childhood, but no interventions specifically target these early risk factors to mitigate future eating disorder risk. This study sought to quantify parents' knowledge of factors influencing eating disorder risk in young children, their concerns about their children’s eating behaviors, and perceived need and preferences for a parent education intervention addressing these topics. Methods: Parents (52 mothers, 55 fathers) of children aged 2-6 completed measures of parental eating disorder symptoms and internalized weight bias and child eating behaviors. Open-ended questions explored parents’ concerns about their children’s …

Affect, Mind-Body Factors, And Disordered And Intuitive Eating Behaviors: Examining Naturalistic Associations Among Young Women With Elevated Eating Disorder Symptoms, Kelly A. Romano

Psychology Theses & Dissertations

Objective: The present study examined whether three mind-body factors—emotion dysregulation, interoceptive sensibility, and mindfulness—that are theorized to be implicated in the onset and maintenance of eating disorder (ED) pathology mediated (Aim 1) and moderated (Aim 2) within-person associations between affect and women with elevated ED symptoms’ disordered and intuitive eating behavior use. Method: Participants included 150 young women with elevated ED symptoms who completed a 10-day ecological momentary assessment protocol. To address Aim 1, multilevel structural equation models examined whether the mindbody factors (separately) mediated momentary associations between negative and positive affect, and women’s disordered (dietary restriction, loss of control …

Contributing Factors To Bulimic Symptoms In A Food-Insecure Population: An Expansion Of The Dual Pathway Model Of Bulimic Pathology, Olivia Rose Seligman

Selected Full-Text Dissertations 2020-

The present study assessed a proposed model developed to explain the relationship between food insecurity and bulimic symptoms (Hazzard et al., 2020). Within this model, body dissatisfaction and food insecurity severity are parallel independent variables. Dietary restraint and shame mediate the relationships between both independent variables and bulimic symptoms (Hazzard et al., 2020). The present sample included 198 adults who were experiencing food insecurity. The majority of participants identified as women (n = 170) and Latina/o (n = 178). Participants completed self-report measures for all variables. On an exploratory basis, body dissatisfaction was measured implicitly. A path analysis was used …

Predictors And Mediators Of Eating Disorder Pathology In Individuals With Eating Disorders, Alexandra Allam

Theses and Dissertations

Over the past decade there has been accumulating evidence that attention-deficit/hyperactivity disorder (ADHD) and eating disorders frequently co-occur, but little is known about the possible mechanisms that might account for their co-occurrence. Likewise, relatively little research has examined the ways such comorbidities impact the maintenance of or recovery from eating disorder (ED) symptoms after treatment. In this cross-sectional study, we recruited 95 adult participants who had received an ED diagnosis and 24-hour treatment for an ED in the past 10 years, and obtained measures of ADHD symptoms and ED symptoms to explore their association and possible mediators thereof. In particular, …

The Connection Between Cptsd And Eating Disorders, Penelope Triantafyllou

Selected Full-Text Master Theses 2021-

Eating Disorders (EDs) are serious mental health conditions proposed to be multifactorial in nature. Post-traumatic stress disorder (PTSD), trauma history, and childhood maltreatment have been noted as possible predictive factors for their development. Research on complex posttraumatic stress disorder (CPTSD) in relation to EDs, however, is limited. The present study aimed to assess the relationship between childhood maltreatment and ED psychopathology, in relation to CPTSD symptomatology as defined by the ICD-11. Relationships between ED symptomatology and the trauma responses associated with the stress or “fight-or-flight” response were analyzed. 167 female participants, aged 18-25, who reported having experienced at least one …

Associations Between Childhood Sexual Abuse And Binge Eating, Kristen Krogh

Psychology Capstone Projects

Childhood sexual abuse is the subject of many studies and analyses. Eating disorders, specifically bulimia nervosa, are also frequently studied to help clinicians gain an understanding of how they develop and the risk factors that make a person more susceptible than their peers. However, binge-eating disorder and its relationship to childhood sexual abuse is not as commonly researched. This paper seeks to investigate the literature available on the overlap between the two topics, childhood sexual abuse and binge-eating disorder. Then articles examining the relationship between the two will be identified and reviewed to determine the state of the literature. Finally, …

Neurocognitive And Momentary Assessment Of Fear-Based Mechanisms Underlying The Transition From Partial To Full Remission In Anorexia Nervosa., Caroline Christian

Electronic Theses and Dissertations

Background. Anorexia nervosa (AN) is a serious psychiatric illness, with high mortality, chronicity, and societal costs. Many individuals with AN that are weight restored do not to fully remit from cognitive-affective symptoms (e.g., fear of weight gain) maintaining the disorder, contributing to the poor outcomes. This critical stage of AN is called partial remission. AN is characterized by high levels of fear and avoidance, which may prevent full remission; however, the role of fear-based mechanisms (i.e., fear approach; avoidance) in partially-remitted AN remains untested. Methods. In the current study (N = 55 partially-remitted AN), participants completed two behavioral paradigms …

Factors Associated With Eating Disorders In Men: A Systematic Review, Zoe Alsup

Psychology Capstone Projects

This systematic review sought to identify factors that are associated with men who experience anorexia or bulimia nervosa or symptoms of these disorders. Articles were included in this review if they were peer reviewed, published in or translated to English, published from 2010 to 2021, had full text accessible, included male participants, and included male participants diagnosed with anorexia and/or bulimia nervosa or who displayed symptoms of anorexia and/or bulimia nervosa. Articles were excluded if they did not meet the inclusion criteria, were a case study, interview, or literature review, or focused on a topic outside of the outcomes of …

Video Chatting And Eating Disorder Psychopathology, Taylor Rae Perry

Legacy Theses & Dissertations (2009 - 2024)

Objective: Due to the COVID-19 pandemic video chatting has been widely used in work, education, and social gatherings. When individuals are video chatting, they can see themselves and see how their looks compare to others. Furthermore, video chatting platforms have features that may enhance an individual’s appearance. Thus, this study sought to investigate if (1) where one’s attention was focused during video chatting was uniquely associated with elevated eating disorder psychopathology and (2) if certain video chatting features were uniquely associated with elevated eating disorder psychopathology. Method: Participants were undergraduates (N=391, Mage=19.19, 58.2% female, and 48.8% White) who completed the …

Investigating The Shared And Unique Mechanisms Of The Development Of Comorbid Eating Disorder-Anxiety Symptoms During Adolescence., Leigh Cara Brosof

Electronic Theses and Dissertations

Introduction: Eating disorders are associated with significant morbidity, psychiatric comorbidity, and impairment. Despite the detrimental outcomes associated with eating disorders, effective treatments for eating disorders are lacking. One factor that has impeded the identification of targets for intervention in eating disorders is the high comorbidity rate with other psychiatric disorders. Comorbidity models can inform treatments by showing which mechanisms are shared in comorbidity and which mechanisms are unique to specific disorders. Anxiety disorders are the most frequently co-occurring disorders with eating disorders, as 85% of individuals with eating disorders have a comorbid anxiety disorder. One mechanistic process in both anxiety …

An In-Depth Examination Of The Literature On Early Pubertal Timing And Disordered Eating In Women And Girls: A Systematic Review And Meta-Analysis, Megan Marie Shope

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: Extant data indicate that earlier onset of puberty increases risk for disordered eating symptoms in girls and women. However, whether earlier pubertal timing is predictive of all disordered eating symptoms, or whether it exerts differential effects across distinct symptoms (e.g., body dissatisfaction versus binge eating), remains unclear given inconsistencies in the literature and the lack of a systematic analysis. A meta-analytic approach can overcome these limitations by providing pooled estimates of early pubertal timing on disordered eating symptoms and testing for methodological moderators (i.e., disordered eating outcome/symptom type, measurement of pubertal timing, age of sample, type of sample, study …

Examining Body Trust And Body Listening In Sexual And Gender Minorities., Emma G. Roberts

College of Arts & Sciences Senior Theses

Introduction: Minority stress theory posits that sexual and gender minority individuals (SGM) may be at higher risk for poor mental health outcomes due to unique social experiences of stigma and discrimination. Interoception (i.e., awareness of one’s body and bodily sensations; Mehling et al., 2012) is a factor that has been linked to mental health broadly, however, SGM individuals may experience interoceptive awareness differently than cisgender and heterosexual individuals given experiences of stigma. In this paper, we aim to examine how two specific facets of interoceptive awareness (body listening and body trusting) relate to differences in mental health outcomes among SGM …

Evaluating The Relationship Between Orthorexia Nervosa, Eating Disorder Symptomatology, And Related Psychological Constructs In An Undergraduate Mixed-Gender Sample, Kimberly Marie Martinez

Legacy Theses & Dissertations (2009 - 2024)

The pursuit of a healthy lifestyle has become a central focus of Western societies over the past few decades. As rates of chronic conditions, such as obesity and type II diabetes, continue to rise, so too has the desire to maintain one’s optimal state of health. For some, the pursuit of a healthy diet becomes an obsession that interferes with one’s physical and psychological wellbeing. Orthorexia Nervosa (ON) is a proposed eating disorder characterized by a pathological fixation on healthy eating. Unlike other established eating disorders (EDs), ON is focused on the quality of one’s diet, rather than the quantity …