Cited by 101Eating Disorders and BehaviorsMental Health Research TopicsAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

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A comparative network analysis of eating disorder psychopathology and co-occurring depression and anxiety symptoms before and after treatment

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Smith, Kathryn E., Mason, Tyler B., Crosby, Ross D., Cao, Li, Leonard, Rachel C., Wetterneck, Chad T., Smith, Brad E. R., Farrell, Nicholas R., Riemann, Bradley C., Wonderlich, Stephen A., Moessner, Markus·2019·Psychological Medicine

DOI 10.1017/s0033291718000867PMC PMC6310232

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Abstract

Background: Network analysis is an emerging approach in the study of psychopathology, yet few applications have been seen in eating disorders (EDs). Furthermore, little research exists regarding changes in network strength after interventions. Therefore the present study examined the network structures of ED and co-occurring depression and anxiety symptoms before and after treatment for EDs. Method: Participants from residential or partial hospital ED treatment programs ( N = 446) completed assessments upon admission and discharge. Networks were estimated using regularized Graphical Gaussian Models using 38 items from the Eating Disorders Examination-Questionnaire, Quick Inventory of Depressive Symptomatology, and State-Trait Anxiety Inventory. Results: ED symptoms with high centrality indices included a desire to lose weight, guilt about eating, shape overvaluation, and wanting an empty stomach, while restlessness, self-esteem, lack of energy, and feeling overwhelmed bridged ED to depression and anxiety symptoms. Comparisons between admission and discharge networks indicated the global network strength did not change significantly, though symptom severity decreased. Participants with denser networks at admission evidenced less change in ED symptomatology during treatment. Conclusions: Findings suggest that symptoms related to shape and weight concerns and guilt are central ED symptoms, while physical symptoms, self-esteem, and feeling overwhelmed are links that may underlie comorbidities in EDs. Results provided some support for the validity of network approaches, in that admission networks conveyed prognostic information. However, the lack of correspondence between symptom reduction and change in network strength indicates that future research is needed to examine network dynamics in the context of intervention and relapse prevention.

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Authors: Smith, K. E., Mason, T. B., Crosby, R. D., Cao, L., Leonard, R. C., Wetterneck, C. T., Smith, B. E. R., Farrell, N. R., Riemann, B. C., Wonderlich, S. A., & Moessner, M.
Affiliations: University of North Dakota (US)
University of Southern California (US)
Neuropsychiatric Research Institute (US)
University Hospital Heidelberg (DE)
Corresponding author: Smith, Kathryn E.
ORCID: Smith, Kathryn E.
Mason, Tyler B.
Crosby, Ross D.
Cao, Li
Leonard, Rachel C.
Wetterneck, Chad T.
Farrell, Nicholas R.
Riemann, Bradley C.
Wonderlich, Stephen A.
Moessner, Markus
Venue: Psychological Medicine
Publisher: Cambridge University Press (CUP)
Published: 2018-04-15
Volume: 49
Issue: 2
Pages: 314-324
ISSN: 0033-2917 (ISSN-L)
1469-8978
DOI: 10.1017/s0033291718000867
PMC: PMC6310232
OpenAlex: W2800157145
Cited by: 101
References: 50
Citations by year: 2026: 4 · 2025: 12 · 2024: 21 · 2023: 20 · 2022: 19 · 2021: 13 · 2020: 5 · 2019: 7
FWCI: 7.33
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.cambridge.org/core/terms (unspecified)
Locations: Psychological Medicine (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Mental Health (T32MH082761)
Topics: Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: eating disorders, depression, anxiety, symptom networks, network centrality, comorbidities, residential treatment, partial hospitalization, treatment outcomes, weight concern, self-esteem, network dynamics, relapse prevention
MeSH terms: Adolescent, Adult, Anxiety, Feeding and Eating Disorders, Depression, Female, Humans, Male, Middle Aged, Models, Statistical, Outcome Assessment, Health Care, Young Adult

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A comparative network analysis of eating disorder psychopathology and co-occurring depression and anxiety symptoms before and after treatment

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