Treatments for adults with eating disorders (EDs) only work in about 50% of individuals, and for some diagnoses (e.g., anorexia nervosa; atypical anorexia nervosa), there are no existing evidence-based treatments. Part of the reason that treatments may only work in a subset of individuals is because of the high heterogeneity present in the EDs, even within diagnoses. Manualized treatments delivered in a standard format may not always address the most relevant symptoms for a specific individual. The current open series trial recruited participants with transdiagnostic ED diagnoses (N = 79) to investigate the feasibility, acceptability, and initial clinical efficacy of a 10-session network-informed personalized treatment for eating disorders. This treatment uses idiographic (i.e., one-person) network models of ecological momentary assessment symptom data to match participants to evidence-based modules of treatment. We found that network-informed personalized treatment was highly feasible with low dropout rates, was rated as highly acceptable, and had strong initial clinical efficacy. ED severity decreased from pre- to posttreatment and at 1-year follow-up with a large effect size. ED cognitions, behaviors, clinical impairment, worry, and depression also decreased from pre- to posttreatment. These data suggest that network-informed personalized treatment has high acceptability and feasibility and can decrease ED and related pathology, possibly serving as a feasible alternative to existing treatments. Future randomized controlled trials comparing network-informed personalized treatment for ED to existing gold standard treatments are needed. Additionally, more research is needed on this type of personalized treatment both in the EDs, as well as in additional forms of psychopathology, such as depression. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Objective: The current systematic and methodological review aimed to critically review existing literature utilizing implicit processing, or automatic approach‐ and/or avoidance‐related attentional biases between eating disorder (ED) and nonclinical samples, which (a) highlights how psychophysiological methods advance knowledge of ED implicit bias; (b) explains how findings fit into transdiagnostic versus disorder‐specific ED frameworks; and (c) suggests how research can address perfectionism‐related ED biases.Method: Three databases were systematically searched to identify studies: PubMed, Scopus, and PsychInfo electronic databases. Peer‐reviewed studies of 18‐ to 39‐year‐olds with both clinical ED and healthy samples assessing visual attentional biases using pictorial and/or linguistic stimuli related to food, body, and/or perfectionism were included.Results: Forty‐six studies were included. While behavioral results were often similar across ED diagnoses, studies incorporating psychophysiological measures often revealed disease‐specific attentional biases. Specifically, women with bulimia nervosa (BN) tend to approach food and other body types, whereas women with anorexia nervosa (AN) tend to avoid food as well as overweight bodies.Conclusions: Further integration of psychophysiological and behavioral methods may identify subtle processing variations in ED, which may guide prevention strategies and interventions, and provide important clinical implications. Few implicit bias studies include male participants, investigate binge‐eating disorder, or evaluate perfectionism‐relevant stimuli, despite the fact that perfectionism is implicated in models of ED.

The aim of the current study was to develop, test, and retest two new male body dissatisfaction scales: The Male Body Scale (MBS; consisting of emaciated to obese figures) and the Male Fit Body Scale (MFBS; consisting of emaciated to muscular figures). These scales were compared to the two most commonly used visually based indices of body dissatisfaction (Stunkard Figure Rating Scale, SFRS; and Somatomorphic Matrix, SM). Male participants rated which body figure on each scale most represented their current figure, then their ideal figure, and then rated which one of the three scales (MBS, MFBS, and SFRS) best represented their current and ideal body overall. Finally, they completed the Drive for Muscularity Scale (DMS), the Eating Disorder Examination Questionnaire (EDE-Q 6.0), and their actual body composition was calculated. This was followed by a retest and manipulation check 2 to 6 weeks later. Participants’ actual body mass index, fat- and muscularity-percentage were all highly related to their current body figure choice, and both new scales were consistently valid and more reliable between test and retest than the SFRS and SM body dissatisfaction scores. Importantly, each scale was sensitive to different types of body dissatisfaction within males. Specifically, the MBS revealed that males’ desire for the thin-ideal significantly corresponded to higher eating disorder tendencies as identified by EDE-Q 6.0 scores, while the MFBS revealed much higher body dissatisfaction toward the larger, muscularity-ideal, predicting higher drive for muscularity as identified by DMS scores. Results validated the new scales, and inform male-focused eating disorder research.

Eating disorders (EDs) are serious psychiatric illnesses with high mortality and societal cost. Despite their severity, there are few evidence-based treatments, and only 50% of individuals respond to existing treatments. This low response rate may be due to the fact that EDs are highly heterogeneous disorders. Precision treatments are needed that can intervene on individual maintenance factors. The first step in such treatment development is identification of central treatment targets, both at the group (i.e., on average) and individual level. The current study (N = 102 individuals with an ED) utilized intensive longitudinal data to model several types of group-level and individual network models. Overall, we identified several group-level central symptoms, with the most common central symptoms of fear of weight gain, desire for thinness, feeling like one is overeating, thinking about dieting, and feeling guilty. We also found that these symptoms, specifically fear of weight gain, a desire to be thinner, thinking about dieting, feeling like one is overeating, and feeling guilty, predicted ED severity at a 1- and 6-month follow-up. We modeled 97 individual networks and found that central symptoms were highly heterogeneous, regardless of ED diagnosis. This work adds to the growing literature using intensive longitudinal data to model ED pathology and implicates fear of weight gain, thinking about dieting, and feelings of guilt as symptoms needing further treatment development work. Additionally, this work contributes essential knowledge on how group and individual network modeling can be used to conceptualize the maintenance of EDs on average and at the individual level. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Theorists have debated whether our ability to understand sarcasm (pertaining here to verbal irony) is principally determined by the context or by properties of the comment itself. The current research investigated an alternative view that broadens the focus on the comment itself, suggesting that mitigating a highly positive concept by using negation generates sarcastic interpretations by default. In the current study, pretests performed on the target utterances presented in isolation established their default interpretations; novel affirmative phrases (e.g., He is the best lawyer) were interpreted literally, whereas equally novel negative counterparts (e.g., He isn’t the best lawyer) were interpreted sarcastically. In Experiment 1 (an eye-tracking study), prior context biased these utterances toward literal or sarcastic interpretations. Results showed that target utterances were easier to process in contexts supporting their default interpretations, regardless of affirmation/negation. Results from a second eye-tracking experiment suggested that readers’ tendency to interpret negative phrases sarcastically is related to their own tendency to use malicious humor. Our findings suggest that negation leads to certain ambiguous utterances receiving sarcastic interpretations by default and that this process may be further intensified by personality factors.