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Cited by 42Eating Disorders and BehaviorsNutrition, Health and Food BehaviorBody Image and Dysmorphia Studies

Clinical insight in anorexia nervosa: Associated and predictive factors

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Gorwood, Philip, Duriez, Philibert, Lengvenyte, Aiste, Guillaume, Sébastien, Criquillion, Sophie·2019·Psychiatry Research
DOI 10.1016/j.psychres.2019.112561
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Abstract

Clinical and cognitive factors associated with clinical insight regarding both baseline level and its time-related changes, in outpatients treated for anorexia nervosa. The 193 participants were recruited at 13 French centers specializing in eating disorders (FFAB network) and assessed for insight (SAI-ED), body mass index (BMI), eating disorder severity, symptoms of depression and anxiety, emotional state, silhouette, and functionality; two cognitive tests were also administered. The 137 patients were then re-assessed 18 weeks later. Minimum and ideal subjective BMI and premorbid intelligence were associated with poor baseline insight. Contrary to nearly all other clinical factors, the level of insight revealed no improvement after four months of care. Only the higher value of the minimum lifetime BMI was significantly predictive of increased insight. More positive emotions (PANAS), less symptoms of depression and anxiety (HADS scores), and fewer syndromes (HADS above threshold) were the only factors that covaried with the changes in the level of insight. In conclusion, poor insight has little time variability, contrary to nearly all clinical and cognitive factors. As increased insight is mainly accompanied by improvements in the emotional domain, the latter could represent potential targets for patients with lack of awareness about their eating disorder.

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  • The etiology of eating disorders is multifactorial, including biological (genetic causes or abnormal neurotransmitter systems) and psychological risk factors such as low self-esteem, body dissatisfaction or obsessive thinking.

    “The etiology of eating disorders is multifactorial, including both biological (genetic causes or abnormal neurotransmitter systems) and psychological risk factors such as low self-esteem, body dissatisfaction or obsessive thinking [2,3,4].”

    From Effects of dog-assisted therapy in adolescents with eating disorders: A study protocol for a pilot controlled trial (2021) · cites this paper as [3]

    The Introduction (section 1; page unavailable) describes distorted beliefs about body weight and shape as characteristics of anorexia nervosa, not as causes or risk factors. Searches for multifactorial etiology, genetic and neurotransmitter causes, low self-esteem, and psychological risk factors found no passage in our copy addressing the claimed causes of eating disorders. (LLM, conf=0.72)

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  1. [13]13. David, A. , 1990. Insight. Lancet. 336(8715), 634.

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Authors
Gorwood, P., Duriez, P., Lengvenyte, A., Guillaume, S., & Criquillion, S.
Affiliations
  • Inserm (FR)
  • Centre Hospitalier Sainte-Anne (FR)
Corresponding author
Gorwood, Philip
ORCID
Venue
Psychiatry Research
Publisher
Elsevier BV
Published
2019-11
Volume
281
Pages
112561
ISSN
0165-1781 (ISSN-L)
DOI
10.1016/j.psychres.2019.112561
OpenAlex
W2972569632
Cited by
42
References
65
Citations by year
2026: 4 · 2025: 7 · 2024: 5 · 2023: 8 · 2022: 5 · 2021: 6 · 2020: 7
FWCI
5.26
Type
journal article
Language
en
Open access
Licence
Locations
  • Psychiatry Research (acceptedVersion)
  • PubMed (publishedVersion)
  • HAL (submittedVersion, cc-by-nc)
Funders
Servier
Topics
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
  • Social Sciences › Psychology › Clinical Psychology › Body Image and Dysmorphia Studies
Keywords
anorexia nervosa, clinical insight, eating disorders, body mass index, premorbid intelligence, depression, anxiety, positive affect, emotional state, cognitive factors, treatment outcomes
MeSH terms
Adult, Anorexia Nervosa, Anxiety, Cognition, Depression, Emotions, Female, Humans, Male, Outpatients, Body Mass Index

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