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Core psychopathology of treatment-seeking patients with binge-eating disorder: a network analysis investigation

Published online by Cambridge University Press:  20 September 2018

Shirley B. Wang
Affiliation:
Department of Psychology, Harvard University, Cambridge, MA, USA
Payton J. Jones
Affiliation:
Department of Psychology, Harvard University, Cambridge, MA, USA
Melissa Dreier
Affiliation:
Department of Psychology, Harvard University, Cambridge, MA, USA
Haley Elliott
Affiliation:
Department of Psychology, Harvard University, Cambridge, MA, USA
Carlos M. Grilo*
Affiliation:
Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
*
Author for correspondence: Carlos M. Grilo, E-mail: [email protected]

Abstract

Background

Mental disorders may emerge as the result of interactions between observable symptoms. Such interactions can be analyzed using network analysis. Several recent studies have used network analysis to examine eating disorders, indicating a core role of overvaluation of weight and shape. However, no studies to date have applied network models to binge-eating disorder (BED), the most prevalent eating disorder.

Methods

We constructed a cross-sectional graphical LASSO network in a sample of 788 individuals with BED. Symptoms were assessed using the Eating Disorders Examination Interview. We identified core symptoms of BED using expected influence centrality.

Results

Overvaluation of shape emerged as the symptom with the highest centrality. Dissatisfaction with weight and overvaluation of weight also emerged as highly central symptoms. On the other hand, behavioral symptoms such as binge eating, eating in secret, and dietary restraint/restriction were less central. The network was stable, allowing for reliable interpretations (centrality stability coefficient = 0.74).

Conclusions

Overvaluation of shape and weight emerged as core symptoms of BED. This trend is consistent with past network analyses of eating disorders more broadly, as well as literature that suggests a primary role of shape and weight concerns in BED. Although DSM-5 diagnostic criteria for BED does not currently include a cognitive criterion related to body image or shape/weight overvaluation, our results provide support for including shape/weight overvaluation as a diagnostic specifier.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2018 

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References

Armour, C, Fried, EI, Deserno, MK, Tsai, J and Pietrzak, RH (2017) A network analysis of DSM-5 posttraumatic stress disorder symptoms and correlates in U.S. military veterans. Journal of Anxiety Disorders 45, 4959.Google Scholar
Beard, C, Millner, AJ, Forgeard, MJC, Fried, EI, Hsu, KJ, Treadway, M and Björgvinsson, T (2016) Network analysis of depression and anxiety symptom relationships in a psychiatric sample. Psychological Medicine 46, 33593369.Google Scholar
Borsboom, D, Mellenbergh, GJ, Van Heerden, J (2003) The theoretical status of latent variables. Psychological Review 110, 203219.Google Scholar
Borsboom, D and Cramer, AOJ (2013) Network analysis: an integrative approach to the structure of psychopathology. Annual Review of Clinical Psychology 9, 91121.Google Scholar
Dubois, RH, Rodgers, RF, Franko, DL, Eddy, KT and Thomas, JJ (2017) A network analysis investigation of the cognitive-behavioral theory of eating disorders. Behaviour Research and Therapy 97, 213221.Google Scholar
Epskamp, S, Borsboom, D and Fried, E (2018) Estimating psychological networks and their accuracy: a tutorial paper. Behavior Research Methods 50, 195212.Google Scholar
Fairburn, CG, Cooper, Z (1993) The eating disorder examination. In Binge Eating: Nature, Assessment, and Treatment (ed. Fairburn, C.G. and Wilson GT, G.T.), pp. 317360. Guilford Press, New York.Google Scholar
Fairburn, CG (2008) Cognitive Behavioral Therapy and Eating Disorders. Guilford, NY: Guilford Press.Google Scholar
Fairburn, CG, Jones, R, Peveler, RC, Hope, RA and O'Connor, M (1993 a) Psychotherapy and bulimia nervosa: Longer-term effects of interpersonal psychotherapy, behavior therapy, and cognitive behavior therapy. Archives of General Psychiatry 50, 419428.Google Scholar
Fairburn, CG, Peveler, RC, Jones, R, Hope, RA and Doll, HA (1993 b) Predictors of 12-month outcome in bulimia nervosa and the influence of attitudes to shape and weight. Journal of Consulting and Clinical Psychology 61, 696698.Google Scholar
Fairburn, CG, Cooper, Z and Shafran, R (2003) Cognitive behaviour therapy for eating disorders: a ‘transdiagnostic’ theory and treatment. Behaviour Research and Therapy 41, 509528.Google Scholar
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW (1997) Structured Clinical Interview for DSM-IV Axis I Disorders—Patient Edition (SCID-I/P, Version 2.0) New York: New York State Psychiatric Institute.Google Scholar
Forbush, KT, Siew, CSQ and Vitevitch, MS (2016) Application of network analysis to identify interactive systems of eating disorder psychopathology. Psychological Medicine 46, 26672677.Google Scholar
Forrest, LN, Jones, PJ, Ortiz, SN and Smith, AR (2018) Core psychopathology in anorexia nervosa and bulimia nervosa: a network analysis. International Journal of Eating Disorders.Google Scholar
Freeman, LC (1978) Centrality in social networks conceptual clarification. Social Networks 1, 215239.Google Scholar
Fried, EI, Epskamp, S, Nesse, RM, Tuerlinckx, F and Borsboom, D (2016) What are “good” depression symptoms? Comparing the centrality of DSM and non-DSM symptoms of depression in a network analysis. . Journal of Affective Disorders 189, 314320.Google Scholar
Fried, EI, van Borkulo, CD, Cramer, AOJ, Boschloo, L, Schoevers, RA and Borsboom, D (2017) Mental disorders as networks of problems: a review of recent insights. Social Psychiatry and Psychiatric Epidemiology 52, 110.Google Scholar
Friedman, J, Hastie, T, Tibshirani, R (2018) Glasso: Graphical Lasso: Estimation of Gaussian Graphical Models. R package version 1.10. https://CRAN.R-project.org/package=glassoGoogle Scholar
Goldschmidt, AB, Hilbert, A, Manwaring, JL, Wilfley, DE, Pike, KM, Fairburn, CG and Striegel-Moore, RH (2010) The significance of overvaluation of shape and weight in binge eating disorder. Behaviour Research and Therapy 48, 187193.Google Scholar
Grilo, CM (2013) Why no cognitive body image feature such as overvaluation of shape/weight in the binge eating disorder diagnosis? International Journal of Eating Disorders 46, 208211.Google Scholar
Grilo, CM (2017) Psychological and behavioral treatments for binge-eating disorder. Journal of Clinical Psychiatry 78, 2024.Google Scholar
Grilo, CM, Masheb, RM and Wilson, GT (2001 a) A comparison of different methods for assessing the features of eating disorders in patients with binge eating disorder. Journal of Consulting and Clinical Psychology 69, 317322.Google Scholar
Grilo, CM, Masheb, RM and Wilson, GT (2001 b) Different methods for assessing the features of eating disorders in patients with binge eating disorder: a replication. Obesity Research 9, 418422.Google Scholar
Grilo, CM, Masheb, RM, Lozano-Blanco, C and Barry, DT (2004) Reliability of the eating disorder examination in patients with binge eating disorder. International Journal of Eating Disorders 35, 8085.Google Scholar
Grilo, CM, Hrabosky, JI, White, MA, Allison, KC, Stunkard, AJ and Masheb, RM (2008) Overvaluation of shape and weight in binge eating disorder and overweight controls: refinement of a diagnostic construct. Journal of Abnormal Psychology 117, 414419.Google Scholar
Grilo, CM, Masheb, RM and White, MA (2010) Significance of overvaluation of shape/weight in binge-eating disorder: comparative study with overweight and bulimia nervosa. Obesity 18, 499504.Google Scholar
Grilo, CM, Masheb, RM, Wilson, GT, Gueorguieva, R and White, MA (2011) Cognitive–behavioral therapy, behavioral weight loss, and sequential treatment for obese patients with binge-eating disorder: a randomized controlled trial. Journal of Consulting and Clinical Psychology 79, 675685.Google Scholar
Grilo, CM, Masheb, RM and Crosby, RD (2013 a) Predictors and moderators of response to cognitive behavioral therapy and medication for the treatment of binge eating disorder. Journal of Consulting and Clinical Psychology 80, 897906.Google Scholar
Grilo, CM, White, MA, Gueorguieva, R, Wilson, GT and Masheb, RM (2013 b) Predictive significance of the overvaluation of shape/weight in obese patients with binge eating disorder: findings from a randomized controlled trial with 12-month follow-up. Psychological Medicine 43, 13351344.Google Scholar
Grilo, CM, Ivezaj, V and White, MA (2015) Evaluation of the DSM-5 severity indicator for binge eating disorder in a community sample. Behaviour Research and Therapy 66, 7276.Google Scholar
Heeren, A and McNally, RJ (2016) An integrative network approach to social anxiety disorder: the complex dynamic interplay among attentional bias for threat, attentional control, and symptoms. Journal of Anxiety Disorders 42, 95104.Google Scholar
Jones, P (2017) networktools: Tools for Identifying Important Nodes in Networks. R package version 1.1.0. https://CRAN.R-project.org/package=networktoolsGoogle Scholar
Jones, PJ, Mair, P, Riemann, BC, Mugno, BL and McNally, RJ (2018) A network perspective on comorbid depression in adolescents with obsessive-compulsive disorder. Journal of Anxiety Disorders 53, 18.Google Scholar
Levinson, CA, Zerwas, S, Calebs, B, Forbush, K, Kordy, H, Watson, H, Hofmeier, S, Levine, M, Crosby, RD, Peat, C, Runfola, CD, Zimmer, B, Moesner, M, Marcus, MD, Bulik, CM (2017) The core symptoms of bulimia nervosa, anxiety, and depression: A network analysis. Journal of Abnormal Psychology 126, 340354.Google Scholar
McNally, RJ (2016) Can network analysis transform psychopathology? Behaviour Research and Therapy 86, 95104.Google Scholar
McNally, RJ, Robinaugh, DJ, Wu, GWY, Wang, L, Deserno, MK and Borsboom, D (2015) Mental disorders as causal systems. Clinical Psychological Science 3, 836849.Google Scholar
McNally, RJ, Mair, P, Mugno, BL and Riemann, BC (2017) Co-morbid obsessive-compulsive disorder and depression: a Bayesian network approach. Psychological Medicine 47, 12041214.Google Scholar
Robinaugh, DJ, Millner, AJ and McNally, RJ (2015) Identifying highly influential nodes in the complicated grief network. Journal of Abnormal Psychology 125, 747757.Google Scholar
Udo, T and Grilo, CM (2018) Prevalence and correlates of DSM-5 eating disorders in nationally representative sample of United States adults. Biological Psychiatry.Google Scholar
Wilfley, DE, Schwartz, MB, Spurrell, EB, Fairburn, CG (1997) Assessing the specific psychopathology of binge eating disorder patients: Interview or self-report? Behaviour Research and Therapy 35, 11511159.Google Scholar
Wilson, GT, Grilo, CM and Vitousek, KM (2007) Psychological treatments of eating disorders. American Psychologist 62, 199216.Google Scholar
Wilson, GT, Wilfley, DE, Agras, WS and Bryson, SW (2010) Psychological treatments of binge eating disorder. Archives of General Psychiatry 67, 94101.Google Scholar
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