Category: Transdiagnostic

Symposium

Eating Disorder Cognitions and Behaviors: Intraindividual Network Analysis to Identify Intervention Targets

Saturday, November 18
1:45 PM - 3:15 PM
Location: Sapphire Ballroom M & N, Level 4, Sapphire Level

Keywords: Eating Disorders
Presentation Type: Symposium

Eating disorders are serious mental illnesses carrying the highest mortality rate of any other mental disorder (Klump et al., 2009). As such, it is necessary to understand what maintains these disorders with the goal to disrupt maintenance factors to treat the disorder. The leading theory of eating disorders is a cognitive behavioral model that suggests that eating disorder cognitions and behaviors maintain and exacerbate these disorders (Fairburn et al., 2010). In the current study we used ecological momentary assessment to assess eating disorder cognitions and behaviors (N = 66 patients diagnosed with an eating disorder; primarily AN; n = 44) across one week including 28 time points. Partial contemporaneous correlation networks were constructed for four individuals using the graphical vector autoregression package (Epskamp, 2016) to test if there were relationships between cognitions and behaviors within individuals. The resulting networks showed relationships between all included cognitions and behaviors, yet there were differences in strength centrality across individuals. For one individual, we found that vomiting had the highest strength centrality in the network (strength = 1.14), followed closely by meal-related thoughts (strength = .92). For a second individual, we found that the weighing behaviors (strength = 1.36), body-checking (strength = 1.28), and excessive exercise (strength = 1.12) had high strength. For a third individual, worry about failure during a meal (strength = 1.54) had the highest strength. For a fourth individual, multiple nodes showed comparable strength centrality, with meal-related thoughts (strength = .66), worry about failure during a meal (strength = .63), binge eating (strength = .64), excessive exercise (strength = .64), and vomiting (strength = .64) showing high strength centrality. These findings offer evidence of notable heterogeneity between individuals in the symptoms that drive and maintain eating disorders. Such information could inform personalized treatment plans to increase treatment effectiveness. For example, a CBT approach may be helpful for the first, third, and fourth individuals to address the interaction between food-related cognitions and compensatory behaviors. The second individual may benefit from a behavioral intervention, as behaviors appear to be predominately driving the network. Further research is needed with more measurement points to evaluate the effectiveness of such network-informed treatment approaches.

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