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Biomedical subjects

Walter Vandereycken

Publications and source records attributed to Walter Vandereycken.

At least 19 recordsLinked to original sources

Action monitoring and perfectionism in anorexia nervosa.

To study action monitoring in anorexia nervosa, behavioral and EEG measures were obtained in underweight anorexia nervosa patients (n=17) and matched healthy controls (n=19) while performing a speeded choice-reaction task. Our main measures of interest were questionnaire outcomes, reaction times, error rates, and the error-related negativity ERP component. Questionnaire and behavioral results indicated increased perfectionism in patients with anorexia nervosa. In line with their perfectionism and controlled response style patients made significantly less errors than controls. However, when controlling for this difference in error rates, the EEG results demonstrated a reduced error-related negativity in the patient group. These seemingly contradictory outcomes of improved performance and reduced error monitoring are discussed in relation with indications of anterior cingulate cortex hypoactivity in anorexia nervosa patients.

Adolescent↗

Impulsiveness and lack of inhibitory control in eating disorders.

UNLABELLED: Eating disorders are considered to lie on a spectrum of disorders with varying degrees of obsessive-compulsive and impulsive traits. Restrictive anorexia nervosa patients (AN-R) are thought to belong to the obsessive pole of the spectrum, and purging-anorexia (AN-P) and bulimia nervosa (BN) patients to the impulsive pole. In this study we have compared impulsive traits in three groups of eating disordered patients (total N=56) and a control group of 83 female students. Information about impulsive traits and lack of inhibitory control was gathered by means of standardized rating scales (Eysenck's Impulsiveness Scale, Barrett's Impulsiveness Scale, and Carver and White's BIS/BAS scale) and a behavioral measure of impulsiveness (stop-go task). On the questionnaires AN-R patients reported to be less impulsive than controls, AN-P and BN patients. In the stop-go task, we did not find significant differences between the different groups. Correlations between self-reported measures of impulsiveness and behavioral measures were not significant. IN CONCLUSION: Our results from the self-report measures are at odds with the behavioral measures certainly in the AN-R group. Perhaps the latter patients' distorted self-perception and/or self-description may explain this discrepancy.

Adolescent↗

Personality prototypes in eating disorders based on the Big Five model.

A three factor model of personality pathology was investigated in a clinical sample of 335 female eating disordered patients. Cluster analysis of the Big Five NEO-FFI scales (Costa & McCrae, 1992) yielded three distinct personality profiles, which were consistent with previous studies: (1) a resilient/high functioning cluster with no clinical elevations on the NEO-FFI scales; (2) an undercontrolled/emotionally dysregulated cluster with elevated scores on the Neuroticism scale and low scores on Conscientiousness and Agreeableness; (3) an overcontrolled/constricted cluster showing high scores on Neuroticism and Conscientiousness and low scores on Openness to Experience. Comparing the three personality prototypes with respect to Axis I and Axis II disorders,resilients reported systematically less clinical and personality problems than both undercontrollers and overcontrollers. Compared to the latter, undercontrollers showed more impulsive personality features and behaviors. Finally, cluster membership was not clearly associated with eating disorder subtypes, suggesting that there is considerable variance in personality features and/or pathology within the various eating disorder categories.

Adolescent↗

Pain experience related to self-injury in eating disorder patients.

A reduced pain sensitivity has been found in eating disorder (ED) patients. These patients often show various types of self-injurious behaviors (SIB) which some experience as painful, while others report analgesia during episodes of SIB. How can we explain these differences? We studied female ED patients (N=185) of whom 84 had admitted some form of SIB in their recent history. The presence/absence of pain report during SIB was not significantly related to the type of ED. The longer the history of SIB, the less pain was reported. Ratings of dissociation and traumatic experiences were higher in patients who did not experience pain while injuring themselves. We discuss several biopsychosocial explanations for these findings with suggestions for future research.

Adolescent↗

Motivation to change in eating disorder patients: a conceptual clarification on the basis of self-determination theory.

OBJECTIVE: The current study critically reviews the different motivational frameworks that are applied in the study of eating disorders and provides a more comprehensive conceptualization of motivation to change on the basis of self-determination theory. METHOD: The most important conceptualizations of motivation to change among eating disorder patients are identified. RESULTS: Eating disorder patients' motivation to change has been defined very differently, adding confusion to the field and preventing research from being cumulative. On the basis of self-determination theory we argue (a) that the quality of motivation to change is primarily reflected in the degree of internalization of change rather than by the intrinsic motivation to change; (b) that the internalization of change suggests more than only the change being initiated from within the person (internal motivation) for it requires an acceptance of the personal importance of change; and (c) that, in addition to its quality, the quantity of motivation to change should be considered too. DISCUSSION: These three conceptual issues are applied to the study of motivational dynamics in eating-disordered patients.

Feeding and Eating Disorders↗

Fast psychomotor functioning in anorexia nervosa: effect of weight restoration.

In a previous study young seriously underweight anorexia nervosa (AN) patients in the early phase of treatment were found to react faster in psychomotor tasks. To further understand this finding we studied the impact of weight restoration on the performance of AN patients in drawing and copying tasks. A group of 17 female AN patients, aged 14 to 25, was compared with 17 healthy controls, matched for sex, age and educational level. Patients were tested when severely underweight and after weight restoration. Control subjects were also tested twice. Using computerized recording and analysis of writing and drawing behavior, reaction times and drawing times were derived, while cognitive and motor demands were manipulated. Overall, AN patients showed shorter reaction times in copying tasks and shorter drawing time in the drawing task than normal controls, and this pattern persisted after weight restoration. No significant group (AN vs. controls) by session (test vs. retest) effect emerged. The finding of a consistent pattern of shorter reaction and drawing times in AN patients before and after weight restoration is compatible with a personality characteristic of perfectionism and overachievement in AN patients.

Adult↗

Differentiation of cognitive and motor aspects in a digit symbol substitution test in Anorexia nervosa patients, before and after weight restoration.

BACKGROUND: In a previous study, using computerized analysis of fine motor behaviour, seriously underweight anorexia nervosa patients in the early phase of treatment were found to have shorter reaction times, but not movement times, in experimental drawing and copying tasks. These differences persisted with weight restoration. SAMPLING AND METHODS: Using computerized analysis of writing and drawing behaviour during the performance of a Digit Symbol Substitution Test, 15 anorexia nervosa patients were compared with 15 normal controls, matched for age, sex and educational level. Patients were retested after weight restoration, as were controls after a similar interval. RESULTS: Patients turned out to be superior in the cognitive, but not in the motor aspects of the Digit Symbol Substitution Test. These differences persisted after weight restoration. A practice effect, due to repeated testing, was found in both groups, which turned out to be cognitive in nature. CONCLUSIONS: The findings show that this new technique can add to the interpretation of classic neuropsychological tests. The results are compatible with previous findings of intact or even superior functioning in anorexia nervosa patients on neuropsychological tasks requiring considerable cognitive effort.

Adolescent↗

Body composition in bulimia nervosa patients compared to healthy females.

OBJECTIVE: In contrast to anorexia nervosa there is a lack of research on body composition in bulimia nervosa patients. The aim of the study was to examine the body composition in underweight, normal-weight and overweight bulimia nervosa patients in comparison with healthy sedentary females, to assess the changes in body composition and subcutaneous fat after five months treatment, and to analyze the relation between body composition variables. DESIGN: The body composition of 138 female bulimia nervosa patients and 188 healthy sedentary females was studied using underwater weighing and skinfold measurements. RESULTS: A good agreement was found between the results obtained by underwater weighing and skinfold measurements. Normal-weight bulimics and control subjects did not differ significantly in body composition. In comparison with healthy controls, underweight and overweight bulimics showed a lower or higher percentage body fat, respectively. In underweight bulimics the fat mass increased after five months of treatment, whereas it decreased in normal-weight and overweight patients in comparison with control subjects. In bulimics more significant relations between body composition variables were found than in the controls. CONCLUSION: Body composition of bulimia nervosa patients may show great differences related to their (varying) body weight. Future research should take the patients' body weight into account.

Adipose Tissue↗

Sleep variables in anorexia nervosa: evolution with weight restoration.

OBJECTIVE: Studies on sleep patterns in anorexia nervosa (AN) have yielded inconsistent results. Therefore, we have studied the evolution of subjective and objective sleep characteristics in AN patients before and after weight restoration. METHOD: Thirty-four severely underweight AN inpatients of the restrictive subtype had a polysomnographic sleep registration at the time of admission and after weight restoration. Subjective sleep quality was also measured with self-report instruments. RESULTS: Objective sleep variables did not change with weight restoration, whereas subjective quality of sleep did improve. Percentage of underweight at admission and amount of slow wave sleep were predictors of the length of time required for weight restoration. DISCUSSION: The finding that weight restoration does not affect polysomnographic sleep variables in AN patients seems to contradict previous studies.

Adult↗

Family environment of eating disordered patients with and without self-injurious behaviors.

OBJECTIVE: The family environment is known to be an important contributor to the course of psychiatric disorders. In this study, we examined the family context of eating disordered (ED) patients with and without self-injurious behaviors (SIB). METHOD: A Dutch adaptation of the Family Environment Scale "Sci Eng 57(9-B):1997;5927" was completed by 131 ED patients of whom 47% showed at least one form of SIB (e.g., cutting, burning, hair pulling, etc.). RESULTS: Results showed a significant difference in family environment between patients with and without SIB. The family environment of self-injuring ED patients was less cohesive, expressive and socially oriented, and more conflictual and disorganized than the family environment of those without SIB. No significant differences in perceived family environment were found with respect to the number or form of SIB and the subtype of ED. Neither did we find a significant interaction effect between ED subtype and presence/absence of SIB.

Adult↗

Hyperactivity in anorexia nervosa: a case study using experience sampling methodology.

Hyperactivity is frequently observed in eating disorders, and several biopsychological mechanisms have been proposed to explain its pathogenetic role. In view of the lack of a reliable method to study hyperactive behavior, we did an experiment with experience sampling methodology (ESM). During 1 week, an anorexia nervosa (AN) patient was asked at nine random times a day to report her momentary tendency to be physically active, her emotions and several other variables including calorie expenditure, drive for thinness, attractiveness, obsessions, compulsions, and attitudes towards hyperactivity. Results indicate that the patient's tendency to be hyperactive was (a) positively related to her weight preoccupation and her negative emotions, and (b) negatively related to her positive emotions and the absence of depression. In this patient, obsessions and compulsions were not related to hyperactivity. The usefulness of ESM for studying the role of hyperactivity in AN is discussed.

Adolescent↗

Personality traits in eating-disordered patients with and without self-injurious behaviors.

Although there is a high comorbidity of eating disorder and self-injurious behavior (SIB), no systematic research has focused on personality trait differences in patients with and without SIB. In this study, a Dutch adaptation of the NEO-FFI (Costa & McCrae, 1985, 1992) was completed by 178 female, eating-disordered (ED) patients of whom 46.5% showed at least 1 form of SIB (e.g., cutting, burning, hair pulling). A subsample of 41 patients also completed the NEO-PI-R. Compared to patients without SIB, ED patients with SIB scored significantly higher on the Neuroticism scale and significantly lower on the Extraversion scale; on subtraits (facet scores) they appeared to be more anxious, more willing to please and less cheerful, efficient and ambitious. Personality traits were not associated with frequency or form of SIB or subtype of ED (except for impulsiveness). We also did not find a significant interaction effect between ED subtype and presence/absence of SIB.

Adult↗

The place of inpatient care in the treatment of anorexia nervosa: questions to be answered.

BACKGROUND: The chance that an anorexia nervosa patient will be hospitalized depends more on circumstantial rather than on scientifically based factors. Although there is a lot of information on the treatment of anorexia nervosa patients in a residential setting, answers to questions relating to the "when," "where," and "how" of treatment are subjective. There is no clinical consensus and the paucity of controlled research is hampering the development of an evidence-based practice. RESULTS: Increasing economic restraints through managed care policies limit the length of inpatient treatment, which leads to early discharge at a lower body weight, which leads to a higher likelihood of readmissions, which leads to increasing costs. DISCUSSION: We will highlight important issues in the ongoing debate between economic demands and clinical challenges. Our goal is to stimulate critical reflections and systematic research.

Anorexia Nervosa↗

Factor-analytic study of the Anorectic Behavior Observation Scale in Japan: comparisons with the original Belgian study.

The Anorectic Behavior Observation Scale (ABOS) is a questionnaire developed to obtain information from relatives about behaviors and attitudes of patients with eating disorders. The original report of the ABOS revealed three factors. This is the first study to confirm the factor structure by use of confirmatory analyses. Relatives of 102 patients with eating disorders completed the ABOS, and exploratory factor analyses were performed. Confirmatory factor analyses were performed for this Japanese sample, and the fitness of the factor structure was compared between that in the original report proposed by Vandereycken and that used in the present study. A three-factor structure was revealed by the data of Japanese patients, including factor I (eating behavior meeting the criteria of anorexia; concern with weight, foods, and denial), factor II (bulimia; including bingeing, disposing, furtive eating and purging, and talk about thinness and dieting), and factor III (hyperactivity, eating slowly, and chopping food into very small pieces). Confirmatory analyses supported the improvement of fitness in this modified three-factor structure in comparison with the original three-factor model. This Japanese ABOS study revealed three dimensions, which differed from the original subscales in Belgium. Cross-cultural differences were observed, though the ABOS may be useful in Japan as an instrument for assessing eating disorders.

Adolescent↗

Therapy-related assessment of self-harming behaviors in eating disordered patients: a case illustration.

Understanding an individual's self-harming behaviors should be the basis for selecting person-specific therapeutic interventions. For that purpose, the assessment is aimed at identifying the self-harming behaviors and related symptoms as well as analyzing the external (situational) and internal (cognitive and emotional) conditions that contribute directly to the instigation of the self-harming behaviors. In this article, we demonstrate the use of a new assessment procedure that may guide the selection of therapeutic interventions. Data collection and processing are illustrated by an individual case study of an eating-disordered patient showing different types of self-harming behavior such as vomiting, alcohol abuse, cutting, and suicide attempts.

Journal Article↗

Fast psychomotor functioning in underweight anorexia nervosa patients.

To explore whether underweight anorexia nervosa patients show psychomotor differences relative to normal controls, 32 female hospitalised patients, aged between 14 and 25 years, were compared with 32 healthy, normal weight controls, matched for sex, age and educational level. Using computerised analysis of writing and drawing behaviour, reaction times and movement times and their different components were analysed, while cognitive and motor demands were manipulated in five drawing and copying tasks. Anorexia nervosa patients were, compared to normal weight controls, significantly faster in a drawing task and showed shorter reaction times in copying tasks. Movement times did not differ significantly between the two groups. In the most complex copying task, a significant group x complexity interaction for reaction time (patients shorter) and reinspection time (patients longer) was found. Patients also made more errors than controls. The finding of a consistent pattern of shorter reaction times in underweight anorexia nervosa patients seems to run contrary to previous findings of disturbed cognitive functioning (i.e. impaired attention) in these patients. The differences seem to be related to cognitive factors more than to motor (executive) components.

Adolescent↗