Submitted by Irene Nascimento (irene.kessia@ufpe.br) on 2017-03-29T19:31:11Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) TESE_MADGE FARIAS FECHINE_.pdf: 4788089 bytes, checksum: 648782ee88724431e5d44996b0235367 (MD5) / Made available in DSpace on 2017-03-29T19:31:11Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) TESE_MADGE FARIAS FECHINE_.pdf: 4788089 bytes, checksum: 648782ee88724431e5d44996b0235367 (MD5) Previous issue date: 2016-05-31 / CAPES / Objetivo: Investigar os efeitos da desnutrição proteica perinatal ou manipulação do sistema serotoninérgico durante a lactação sob o comportamento alimentar compulsivo após ciclos de Restrição/Realimentação (R/R). Materiais e métodos: Foram formados quatro grupos conforme os tratamentos dietéticos e farmacológicos: Controle (17% caseína na vida perinatal) e Desnutrido (8% caseína na vida perinatal); Salina (10mg/Kg) e Fluoxetina (10mg/Kg) foram submetidos a três consecutivos ciclos de Restrição/Realimentação (ciclos R/R). Cada ciclo R/R é composto por uma fase de restrição (4 dias com 40% do consumo individual médio de dieta padrão nos 7 dias antes de iniciar os ciclos R/R) seguida por uma fase realimentação (4 dias com dieta padrão ad libitum). Assim, os quatro grupos anteriormente descritos foram subdivididos ou não de acordo com a fase de restrição dos ciclos R/R para formar oito grupos: Grupos não restritos [Controle Naïve (CN) n=6 e 10 ou Desnutrido Naïve (DN) n=7 e 11 e Salina Naïve (SN) n=13/15 ou Fluoxetina Naïve (FN) n=12/13] e Grupos restritos [Controle Restrito (CR) n=6 e 11 ou Desnutrido Restrito (DR) n=7 e 10 e Salina Restrito (SR) n=11/13 ou Fluoxetina Restrito (FR) n=13/14]. Após os três ciclos R/R, todos os animais foram submetidos ao teste alimentar (dieta padrão e palatável por 24hs). Após uma semana, os animais dos grupos [Controle Naïve (CN) n=10 ou Controle Restrito (CR) n=11 e Desnutridos Naïve (DN) n=11 ou Desnutrido Restrito (DR) n=10] foram submetidos a um teste de privação alimentar (24hs sem dieta padrão) e em seguida receberam dieta palatável (2hs) e dieta padrão (22hs). Já todos os animais dos grupos Salina e Fluoxetina, aos 120 dias de vida foram submetidos a outro teste alimentar semelhante ao primeiro teste alimentar (após os ciclos R/R). Resultados: Após ciclos R/R os animais Desnutrido Restrito demonstraram hiperfagia por dieta palatável comparados com os animais do grupo Controle Naïve, como também aumentaram o peso corporal sugerindo o desenvolvimento de obesidade. Contudo, estes animais perderam a capacidade para aumentar o consumo de dieta palatável quando estavam com fome, após a privação alimentar. Em relação aos grupos Salina e Fluoxetina não houve diferenças significativas no consumo alimentar (dieta palatável e padrão) nos dois testes alimentares. Conclusão: Desnutrição proteica perinatal ou tratamento de fluoxetina no aleitamento não contribuem para o desenvolvimento de compulsão alimentar após três ciclos R/R. / Objective: To investigate the effects of the perinatal protein undernourishment or manipulation of the serotonergic system in breastfeeding on the binge eating behavior after Restriction/Refeeding cycles (R/R cycles). Materials and methods: Four groups were formed as dietary and pharmacological treatments: Control (17% casein in perinatal life) and Undernourished (8% casein in perinatal life); Saline (10mg/kg) and Fluoxetine (10mg/kg) were submitted to three consecutive cycles of Restriction/Refeeding cycles (R/R cycles). Each R/R cycle was composed of a restriction phase (4 days with 40% of the mean individual consumption standard diet 7 days before starting cycles R/R) followed by a feedback phase (4 days with a standard diet ad libitum). Thus, the four groups described above were subdivided or not according to the restriction phase of R/R cycles to form eight groups: not restricted Groups [Control Naïve (CN) n=6 and 10 or Undernourished Naïve (UN) n=7 and 11 and Saline Naïve (SN) n=13/15 or Fluoxetine Naïve (FN) n=12/13] and Restricted Groups [Restricted Control (CR) n=6 and 11 or Undernourished Restricted (DR) n=7 and 10 and Saline Restricted (SR) n=11/13 or Fluoxetine Restricted (FR) n=13/14]. After three R/R cycles, all animals were subjected to the feeding test (standard diet and palatable food for 24hrs). After one week, the animals of the groups [Control Naïve (CN) n=10 or Restricted Control (CR) n=11 and Undernourished Naïve (DN) n=11 or Undernourished Restricted (UR) n=10] were subjected to a test food deprivation (24hrs without standard diet) and then received palatable food (2hrs) and standard diet (22hrs). Already all the animals of Saline and Fluoxetine groups at 120 days of age were subjected to a similar feeding test the first test (after R/R cycles). Results: After R/R cycles the Restricted Undernourished animals showed hyperphagia by palatable food compared to animals Naïve control group, as well as increased body weight suggesting the development of obesity. However, these animals have lost the ability to increase the intake of palatable food when they were hungry after food deprivation. Regarding Saline and Fluoxetine groups there was not significant differences in food intake (standard diet and palatable food) in both feeding tests. Conclusion: Perinatal protein undernourishment or treatment of fluoxetine in breastfeeding do not contribute to the development of binge eating after three R/R cycles.

There is evidence that functions related to attachment may play an important role in the etiology and maintenance of eating disorders, particularly anorexia and bulimia nervosa (Kuipers & Bekker, 2012; Tasca & Balfour, 2014). However, there is little research available on attachment functioning in those with binge-eating disorder (BED). This dissertation consists of three studies that examine the role of attachment states of mind and attachment dimensions in understanding BED and co-morbid overweight, and to examine mechanisms related to group treatment response for those with BED. The first study assessed attachment state of mind classifications (i.e., attachment categories) to understand better: 1) the psychopathology and maintenance of BED and co-morbid overweight, and 2) the treatment response of women with BED who receive Group Psychodynamic Interpersonal Psychotherapy (GPIP; Tasca, Mikail, & Hewitt, 2005). Overweight women with BED (subsequently referred to as women with BED), overweight women without BED, and normal weight women without BED completed the Adult Attachment Interview (AAI; Main, Goldwyn, & Hesse, 2002). Those with BED completed the AAI pre- and six months post- GPIP and those without BED completed the AAI at one-time point. Women with BED have significantly higher rates of insecure (preoccupied) and unresolved/disorganized attachment states of mind compared to normal weight women without BED. Women with BED had similar rates of insecure and unresolved/disorganized attachment states of mind as overweight women without BED. With respect to treatment completers, changes in attachment states of mind were not statistically significant. However, follow-up analyses indicated clinically meaningful changes which are discussed in the study. The second study used attachment dimensions of coherence of mind and reflective functioning (measured using the AAI) to add to our understanding of the psychopathology and maintenance of BED and co-morbid overweight. Higher Reflective Functioning scores differentiated normal weight women from both women with BED and overweight women without BED, and the latter two groups did not differ from each other. Coherence of Mind scores did not differentiate the groups. The third study used attachment dimensions of coherence of mind and reflective functioning to understand better group psychotherapy response for those with BED who received GPIP. Greater reflective functioning at pre-treatment was associated with a decline in binge eating frequency at 12 months post-treatment. Pre-treatment levels of coherence of mind was not related to group treatment outcomes. Reflective Functioning scores significantly improved from pre- to six months post-treatment. Further, more than 39% of participants demonstrated clinically reliable improvement and almost 32% experienced clinically reliable recovery with respect to reflective functioning. These results were moderated by pre-treatment self-reported attachment anxiety. That is, those with lower attachment anxiety showed significant improvement in reflective functioning, whereas those with higher attachment anxiety did not show this improvement. A third of participants experienced clinically significant improvement in coherence of mind, but this change was not statistically significant. Overall, attachment dimensions and attachment state of mind classification contribute to our understanding of the etiology and maintenance of BED and co-morbid overweight, as well as to our understanding of the group treatment response of those with BED. Addressing attachment insecurity and low reflective functioning in those with BED may improve treatment outcomes.

Die Arbeit beschäftigt sich mit dem Nachweis eines Aufmerksamkeit-Bias auf visuelle Nahrungsreize bei Personen mit Binge-Eating-Störung, im Vergleich zu Personen ohne Essstörungssymptome via Eye-Tracking.

Bakgrund: Ett av symtomen för hetsätningsstörning är att inte ha kontroll över den mängd mat som äts. Individen får i sig mer mat än vad kroppen behöver under en kort period, vilket över tid kan leda till komplikationer för hälsan såsom fetma, diabetes och kardiovaskulära sjukdomar. Stöd från sjuksköterskan, familj och närstående kan leda till en bättre återhämtningsprocess för individen samt att individen lättare kan nå sina mål. Syfte: Syftet var att belysa kvinnors upplevelse av hetsätningsstörning. Metod: Studien genomfördes som en litteraturstudie med en induktiv ansats där nio vetenskapliga artiklar granskats med hjälp av en innehållsanalys. Resultat: I resultatet framkom tre kategorier: hetsätning som en hanteringsmekanism för stress, negativa känslor associerade med hetsätning och känslan av att inte kunna sluta äta. Konklusion: Kvinnorna upplever att de hanterar stress och ångest bättre när de hetsäter, men hetsätningen orsakar viktuppgång, vilket i sin tur leder till mer ångest. Ångesten utlöses bland annat av att inte kunna leva upp till samhällets bild av den perfekta kroppen. Att ständigt hetsäta leder till matvanor som gör att individen inte kan begränsa sitt matintag.

Objective: Binge-eating disorder (BED) in adults is associated with alterations in executive functions (EF) and obesity. Much less is known about these relationships in adolescents, including whether poor EF are associated with eating disorder psychopathology and/or elevated body mass index. The present study examined EF in response to neutral stimuli in youth with BED. Method: Adolescents with BED and obesity (n=22), individually matched adolescents with obesity (n=22), and normal weight (n=22) completed neuropsychological tests targeting inhibition (Color-Word Interference Test), sustained attention (D2 Concentration Endurance Test), cognitive flexibility (Comprehensive Trail Making Test), and decision-making (Iowa Gambling Task). Results: Adolescents with BED and obesity displayed significantly poorer inhibitory control compared to normal-weight adolescents. This effect persisted after controlling for the level of secondary education. However, initial differences between adolescents with obesity and normal-weight controls regarding inhibitory control and sustained attention vanished after controlling for education. The three groups did not differ regarding cognitive flexibility and decision-making. Moreover, adolescents with BED and obesity did not perform worse than adolescents with obesity on any of the neuropsychological tests. Discussion: Overall, our results indicate adolescent BED is associated with only a few alterations in general EF, specifically inhibitory control, and underline BED and educational level as confounding factors in neuropsychological research on obesity. To further delineate EF profiles of adolescents with BED, future research should focus on EF in response to disorder-related stimuli and experimental settings with high ecological validity.

To provide a basis for electroencephalography (EEG) neurofeedback protocols for bulimianervosa (BN), binge-eating disorder (BED), and obesity, this systematic review investigates alterations in EEG-measured brain activity, specifically frequency bands. A systematic literature search with pre-defined search terms yielded N = 7 studies meeting the inclusion criteria. The risk of bias was assessed for all studies. In resting-state EEG, the beta activity was elevated in fronto-central regions in individuals with obesity and comorbid BED. In food-cue conditions, both obese individuals with and without BED showed increased beta activity, suggesting increased awareness of food cues and a heightened attentional focus towards food stimuli. The level of beta activity was positively correlated with eating disorder psychopathology in resting and food-cue conditions. In individuals with BN, there was no evidence for altered EEG spectral power. The results indicate specific alterations in EEGbased brain activity in individuals with BED and obesity. More high-quality studies are needed to further confirm these findings and to transfer them into EEG-based interventions.

No description available.

Findings on executive functions (EFs) in binge-eating disorder (BED) are inconsistent and possibly biased by associated comorbidities. This study aimed to identify whether distinct levels of physical and mental comorbidity are related to EFs in BED. General and food-specific EFs in n = 77 adults with BED were compared to population-based norms and associations with weight status, depressive symptoms, and eating disorder psychopathology were analyzed. To detect within-sample patterns of EF performance, k-means clustering was applied. The results indicated that participants’ general EFs were within the average range with slight deficits in alertness. While depression and eating disorder psychopathology were unrelated to EFs, weight status was associated with food-specific attentional bias that was significantly higher in obesity class 2 than in overweight/obesity class 1 and obesity class 3. Four meaningful clusters with distinct strengths and impairments in general and food-specific EFs but without differences in clinical variables were identified. Altogether, adults with BED showed few specific deficits compared to normative data. Performance was unrelated to depression and eating disorder psychopathology, while weight status was associated with food-specific EFs only. The results highlight the need for longitudinal studies to evaluate the relevance of EFs in BED development and maintenance in neurologically healthy adults.

Background: Individuals with binge eating disorder (BED) experience a loss of control (i.e., poor inhibitory control) during binge eating, where stress is a common antecedent for binge episodes. However, few studies examine acute stress in BED and, to date, psychosocial stress relationships with inhibitory control are unexamined. Purpose: The current study investigated acute psychosocial stress effects on inhibitory control in BED. Additionally, inhibitory control relationships with BED treatment outcome were explored. Methods: Thirty-three individuals with BED were randomized to a stress (n = 17) or no stress condition (n = 16). All completed self-report measures including the Profile of Mood States and the Binge Urge Scale. Following the stressor, individuals completed the Stop-Signal Task (SST), a well-validated measure of inhibitory control. Relationships between post-stress anxiety with inhibitory control and eating pathology were explored. Furthermore, treatment outcome relationships with levels of inhibitory control, and negative urgency (an impulsive personality trait) were explored. Results: In the stress condition, individuals reported increased state anxiety immediately following stress, but experienced a decrease back to baseline levels of anxiety by the end of the SST. Stress resulted in impaired inhibitory control performance on the SST. Binge urges increased across both conditions over time. Measures of inhibitory control and negative urgency did not relate to treatment outcome. Conclusion: This study is novel in directly examining psychosocial stress effects on inhibitory control, which has not been studied in BED. These results show subjective stress effects in BED are short-lived; however, behaviourally, stress has a lingering effect on inhibitory control. Increasing binge urges across the experimental session in the no stress condition suggests a role for generalized anxiety on this impulse. These findings have clinical implications for binge urges as a therapeutic target, and for informing individuals with BED about the implications of stress on their binge eating. / Thesis / Master of Science (MSc)

Research suggests that the associations between femininity, body image and eating disorders are intricate. How these constructs are linked to each other still needs to be determined. The purpose of this study was to gain a deeper understanding of these links, examining the mediational relationship among these constructs. Also, the prediction that bulimia and binge eating disorder symptoms have a similar origin was tested and compared. Some researchers have suggested that the pathways leading to these disorders are equivalent and the main difference between the two is the dietary restriction, while others see them as distinct disorders with different etiology. A total of 355 female college students (ages 18 to 26) completed a set of questionnaires that assessed femininity, feminine gender role stress, body dissatisfaction, bulimia, and binge eating disorder. Results showed that body dissatisfaction mediates the relationship between femininity or feminine gender role stress with bulimia symptoms, as well as the relationship between feminine gender role stress and binge eating disorder symptoms. Results indicate that body dissatisfaction related to femininity or to feminine gender role stress may contribute to higher levels of bulimia symptoms. The findings also suggest that body dissatisfaction related to feminine gender role stress may contribute to higher levels of binge eating disorder symptoms. Results did not support the mediational role of body dissatisfaction between femininity and binge eating disorder. However, the mediational role of feminine gender role stress between femininity and body dissatisfaction was partially supported, suggesting that feminine gender role stress might only be one pathway by which femininity may have an impact on body dissatisfaction. / Master of Science