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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: carlos.grilo@yale.edu

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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