@article{pmid42410482,

title = {Shared and Distinct Clinical Features in Treatment-Seeking Adults With Avoidant/Restrictive Food Intake Disorder or Anorexia Nervosa Subtypes},

author = {Vittoria Trolio and Linda Booij and Samantha Ginsberg and Sarah E Racine and Howard Steiger},

doi = {10.1002/eat.70167},

issn = {1098-108X},

year  = {2026},

date = {2026-07-01},

journal = {Int J Eat Disord},

abstract = {OBJECTIVE: Available studies comparing clinical features in treatment-seeking adults with avoidant/restrictive food intake disorder (ARFID) to anorexia nervosa (AN) often do not distinguish between AN-restricting (AN-R) and AN-binge-eating/purging (AN-B/P) subtypes, rely on retrospective ARFID diagnoses, and include unequal group sizes. Across relatively balanced study groups, we compared eating disorder symptoms, concurrent psychiatric symptoms, and Big Five personality traits in treatment-seeking adults with ARFID, AN-R, or AN-B/P to identify unique and shared features.nnMETHODS: Participants were adults (29 ARFID, 39 AN-R, 45 AN-B/P) diagnosed via semi-structured clinical interviews at the start of outpatient treatment. Data were analyzed with general linear models.nnRESULTS: On measures of shape-/weight-centered eating pathology and depression, individuals with ARFID scored lower than did those with AN-R (ps < 0.05) or AN-B/P (ps < 0.001). On measures of anxiety, individuals with ARFID scored lower than did those with AN-B/P (p < 0.001) but not AN-R (p = 0.075). Compared with AN groups, the ARFID group had less total emotion-regulation difficulties (p < 0.001). There were no group differences on Big Five personality traits (p = 0.173), including neuroticism.nnDISCUSSION: Treatment-seeking adults with ARFID reported less shape-/weight-centered eating pathology, depression, anxiety, and emotion-regulation difficulties than did individuals with AN but did not differ on endorsement of Big Five personality traits. Findings suggest that individuals with ARFID display less pronounced psychopathology on assessed domains than do those with AN and highlight potential directions for future ARFID research.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid41736559,

title = {Changes in Psychosocial Outcomes Reported in Behavioral Intervention Trials for Children and Adolescents with Overweight and Obesity: A Scoping Review},

author = {Cathy Kwok and Sabrina Sacco and Natalie B Lister and Angela S Alberga and Louise A Baur and Linda Booij and Kimberly Carrière and Sarah P Garnett and Hiba Jebeile},

doi = {10.1177/21532176261418755},

issn = {2153-2176},

year  = {2026},

date = {2026-04-01},

journal = {Child Obes},

volume = {22},

number = {3},

pages = {187--205},

abstract = {BACKGROUND: Pediatric obesity is associated with co-occurring psychosocial conditions, which may be impacted by obesity treatment. Past systematic reviews have shown positive effects for specific psychosocial outcomes following behavioral interventions. This review aimed to extend these findings by mapping patterns of change for the totality of psychosocial outcomes reported.nnMETHODS: We conducted a scoping review following published guidelines. We searched 11 databases to identify behavioral intervention trials for children and adolescents living with overweight or obesity that measured at least one psychosocial outcome pre-post. Outcomes were grouped into categories thematically, and data were synthesized based on the timepoint (post-intervention, latest follow-up), intervention arm (active, no-intervention control), and type of change reported (difference between arms, change over time).nnRESULTS: Of 1172 articles screened, 197 articles (169 trials) met the inclusion criteria, with a combined sample of 18,694 children and adolescents. A total of 372 outcomes were identified and grouped into eight constructs. Across all outcomes and timepoints, many trials reported no difference or a difference favoring the active intervention arm over the no-intervention control arm. Likewise, most active intervention arms showed improvements or no change over time, though five of 169 trials reported worsening in a psychosocial outcome at post-intervention. Most no-intervention control arms showed no change over time.nnCONCLUSIONS: Behavioral interventions are associated with improvements or no change in psychosocial health across a broad range of outcomes assessed. Consensus on core psychosocial outcomes is needed to reduce heterogeneity and ensure outcomes are relevant to children and adolescents living with obesity.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid41765047,

title = {World Federation of Societies of Biological Psychiatry (WFSBP) consensus statement on candidate biomarkers for anorexia nervosa},

author = {Hubertus Himmerich and Johanna Louise Keeler and Joseph A King and Stefan Ehrlich and Lisa-Katrin Kaufmann and Cynthia M Bulik and Sarah Cohen-Woods and Tracey Wade and Howard Steiger and Linda Booij and Palmiero Monteleone and Giammarco Cascino and Alessio Maria Monteleone and Ulrich Cuntz and Ulrich Voderholzer and Selamawit Alemayehu Tessema and Yael D Lewis and Magnus Sjögren and Johannes Hebebrand and Jochen Seitz and Marta Tyszkiewicz-Nwafor and Olga Karpenko and Hiba Mutwalli and Sergueï O Fetissov and Isabelle Mack and Namrata Dhopatkar and Sabrina Mörkl and Carol Kan and Maria M Uribe and Kazuhiro Yoshiuchi and Nadine Abuobeid and Dimitrios Kapogiannis and Daniel Stein and Sevgi Bektas and Daniel J Müller and Philip Gorwood and Philibert Duriez and Chloé Tezenas du Montcel and Elżbieta Paszyńska and Susan L McElroy and Wiesława Dominika Wranik and Fernando Fernandez-Aranda and Philip S Mehler and Hana Papežová and Radka Roubalová and Petra Procházková and Rebecca Morris and Piotr Lewczuk and Christoph Hiemke and Michael Berk and Andreas Karwautz and Janet Treasure and Siegfried Kasper and  and },

doi = {10.1080/15622975.2026.2626934},

issn = {1814-1412},

year  = {2026},

date = {2026-04-01},

journal = {World J Biol Psychiatry},

volume = {27},

number = {4},

pages = {257--348},

abstract = {OBJECTIVES: This World Federation of Societies of Biological Psychiatry (WFSBP) consensus paper aims to summarise and evaluate the published study results on objectively measurable biological markers associated with anorexia nervosa (AN).nnMETHODS: The relevant literature was reviewed by the WFSBP Task Forces on Eating Disorders and on Biological Markers, and a consensus regarding the significance of the published evidence was reached.nnRESULTS: Candidate biological markers that have been associated with AN include clinical (e.g. body weight), molecular (e.g. genetic, epigenetic, hormonal, immunological, metabolomic), cellular (e.g. leukocytes), neuroimaging (e.g. structure, function, connectivity), digital, cardiac and neurophysiological parameters. Some clinical and laboratory parameters are risk markers in clinical practice. Biological markers have pathophysiological relevance in understanding the biological and metabolic pathophysiology of AN and its physical health consequences. Few studies have examined pharmacogenetics or therapeutic drug monitoring as tools to monitor and guide the treatment of AN.nnCONCLUSIONS: Biological markers will hopefully soon enable clinicians to intervene earlier in a more targeted manner to mitigate treatment resistance. However, the current scientific basis for most biological markers are group comparisons only. Studies on sensitivity, specificity and the prognostic value of these markers are lacking.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid41965343,

title = {Advancing translational research in binge-eating: Integrating insights from clinical practice into animal models},

author = {Rachel Dufour and Uri Shalev and Linda Booij},

doi = {10.1038/s41398-026-04035-0},

issn = {2158-3188},

year  = {2026},

date = {2026-04-01},

journal = {Transl Psychiatry},

volume = {16},

number = {1},

abstract = {Binge-eating behaviors are key components of several types of eating disorders, yet their etiology remains unclear. Animal models have provided valuable insights by enabling experimentally controlled investigations of biological, behavioral, and environmental factors contributing to eating disorders. This narrative review examines the clinical relevance of animal models in advancing our understanding of binge-eating-related disorders. We propose five translational priorities focused on clinically-meaningful features of binge eating and their relevance for improving animal-model development: (1) loss of control and compulsivity, (2) negative affect and stress responsivity, (3) developmental timing and sex differences, (4) individual differences and variability, and (5) treatment responsiveness. Various animal models, including food restriction, stress-induced, and addiction-based paradigms, have been developed to study binge eating. Limitations include the inability of animal models to fully capture the psychological and sociocultural dimensions of binge eating, such as the sense of loss of control, stigma, distress, and body-image concerns. While existing models capture key biological and behavioral components of binge eating, closer alignment with clinically defining features, for example, through the inclusion of emotional stressors and varied outcome measures, could improve translational impact. By refining current models to match clinical reality, animal research may continue to enhance our understanding of eating disorders and inform the development of novel treatment approaches.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid41601261,

title = {Psychosocial Outcomes Reported in Randomized Behavioral Intervention Trials for Children and Adolescents with Overweight and Obesity: A Scoping Review},

author = {Sabrina Sacco and Linda Booij and Cathy Kwok and Kimberly Carrière and Katharine Hall and Trisha C Baluyot and Vida Forouhar and Marilou Côté and Martha Pietrasik and Hiba Jebeile and Geoff D C Ball and Bradley C Johnston and Angela S Alberga},

doi = {10.1177/21532176251408689},

issn = {2153-2176},

year  = {2026},

date = {2026-03-01},

journal = {Child Obes},

volume = {22},

number = {2},

pages = {110--136},

abstract = {BACKGROUND: Many children and adolescents with overweight or obesity experience negative psychosocial health consequences. Systematic reviews show that behavioral interventions can help improve specific psychosocial outcomes. This scoping review aims to identify and map the different types of psychosocial outcomes measured and reported in randomized behavioral intervention trials for managing pediatric overweight and obesity.nnMETHODS: A total of 11 databases were searched until February 2024. We included randomized behavioral intervention trials for children and adolescents (≤18 years) with overweight or obesity that report at least one psychosocial outcome.nnRESULTS: Overall, 197 articles reflecting 169 behavioral intervention trials were included. To assess the psychosocial outcomes captured, among 169 trials, 174 different measures were identified (e.g., self- and proxy-reported questionnaires). The psychosocial outcomes were organized into nine categories. The most frequently reported outcome categories were (1) emotional and behavioral functioning ( = 79 outcomes); (2) eating attitudes, behaviors, and body image ( = 72 outcomes); and (3) quality of life ( = 68 outcomes). Among all psychosocial outcomes captured, most outcomes were reported among older children and adolescents (78.4%) and for interventions with a duration of up to 26 weeks (75.1%).nnCONCLUSIONS: This scoping review identified a variety of psychosocial outcomes across different behavioral intervention trials and a variety of measures used to assess them. Evidence among younger samples and regarding the long-term effects of behavioral intervention trials on psychosocial health is limited. Identifying the core outcomes as well as a psychometric evaluation of the measures identified is needed.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid41708267,

title = {Atypical (Other or Unspecified) Feeding or Eating Disorders: Diagnosis, Clinical Implications, and Treatment},

author = {Howard Steiger and Linda Booij},

doi = {10.1016/j.psc.2025.08.003},

issn = {1558-3147},

year  = {2026},

date = {2026-03-01},

journal = {Psychiatr Clin North Am},

volume = {49},

number = {1},

pages = {37--49},

abstract = {Atypical eating disorders (EDs) appear to be comparable to classical eating-disorder variants with regard to eating-symptom severity, illness burden, concurrent mental-health problems, medical complications, etiology, and treatment needs. It remains to be determined to what extent atypical EDs are truly distinct from classical variants, or simply represent early or residual phases of these disorders. Available evidence suggests that, except for variants for which symptom-specific treatment elements are indicated, conventional eating-disorder treatments are also well-suited for the treatment of atypical EDs.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid41776720,

title = {Effectiveness of a Low-Intensity Self-Guided Psychoeducational Intervention for Individuals Waitlisted for Specialised Eating-Disorder Treatment: A Randomised Controlled Trial},

author = {Linda Booij and Barbara Barth and Micaël Thériault and Bronwyn Raykos and Peter McEvoy and Howard Steiger},

doi = {10.1002/erv.70093},

issn = {1099-0968},

year  = {2026},

date = {2026-03-01},

journal = {Eur Eat Disord Rev},

abstract = {OBJECTIVE: Gaining access to evidence-informed treatment for eating disorders (EDs) is challenging, and this creates interest in the possible benefits of self-help treatment methods. We investigated the effectiveness of receiving evidence-informed self-guided psychoeducation, delivered to individuals while on a waitlist for specialised ED care.nnMETHOD: While waitlisted for treatment, 62 adults were randomised to one of two 4-week conditions: (a) Weekly psychoeducation related to EDs via email (Experimental condition); or (b) No psychoeducation (Control condition). Participants completed weekly measures of ED attitudes (ED-15), body satisfaction (Body Satisfaction Scale) and motivation to change (Readiness Ruler).nnRESULTS: Participants in the experimental condition showed a greater reduction in ED-15 scores after 4 weeks of exposure to the psychoeducational materials compared to control participants. Effect sizes were in the small-to-medium range, with the strongest effects observed among individuals who were engaging in binge/purge behaviours. There were no effects on body satisfaction or motivation to change. Participants reported being reasonably engaged and satisfied with the materials.nnCONCLUSIONS: Delivering low-intensity self-guided psychoeducation appears to be effective in reducing ED attitudes and preoccupations among people waitlisted for specialised ED services, especially those presenting with bulimic symptoms. However, the intervention seemed not to impact motivation for change.nnTRIAL REGISTRATION: The trial was registered retroactively at Clinicaltrials.gov (NCT07319936).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40947104,

title = {Exposure to Metal Mixtures and Childhood Adiposity: An Examination of Periods of Heightened Susceptibility Between Gestation and Late Childhood},

author = {Janice M Y Hu and Michael M Borghese and Mandy Fisher and Joseph M Braun and Katherine M Morrison and Mark R Palmert and Linda Booij and Constadina Panagiotopoulos and Jillian Ashley-Martin},

doi = {10.1111/ijpo.70057},

issn = {2047-6310},

year  = {2025},

date = {2025-12-01},

journal = {Pediatr Obes},

volume = {20},

number = {12},

pages = {e70057},

abstract = {INTRODUCTION: Childhood obesity is a public health concern. Studies have investigated the effects of metal mixtures on childhood obesity but none have identified periods of heightened susceptibility of exposure. We identified the periods by investigating the association of metal mixture, measured at four time points, with adiposity.nnMATERIALS AND METHODS: Using data from the Maternal-Infant Research on Environmental Chemicals Research Platform, we included 234 child-parent pairs. We measured whole blood metal concentrations during the first and third trimesters, early and late childhood. Outcomes were late childhood body mass index z-score (zBMI), body fat percentage (%BF) and waist circumference z-score (zWC). We used treed distributed lag mixture models (TDLMM) to investigate associations between metal mixture and adiposity. We also investigated associations using linear regression and conducted sex-specific analysis.nnRESULTS: Among females, arsenic was positively associated with zBMI and zWC. Regression results show that each doubling in third trimester arsenic concentrations was associated with 0.16 (95% CI: 0.02, 0.31) and 0.13 (95% CI: 0.01, 0.25) increase in zBMI and zWC, respectively. TDLMM results were similar but attenuated. We also observed negative associations between third trimester cadmium and zWC, null associations between other metals and adiposity and among males and no metal interactions.nnCONCLUSION: Third trimester is a period of heightened susceptibility to obesogenic effects of arsenic exposure in females.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid41154942,

title = {Associations Between Walking in the Third Trimester of Pregnancy and Maternal Mental Health During the COVID-19 Pandemic},

author = {Angélique Brun and Stephanie-May Ruchat and Sophie Chaput-Langlois and Linda Booij and Raphaëlle Giac and Katherine Séguin and Andréanne Bernier and Anne-Sophie Morisset and Isabelle Boucoiran and Cathy Vaillancourt and Sarah Lippé and Catherine M Herba},

doi = {10.3390/ijerph22101538},

issn = {1660-4601},

year  = {2025},

date = {2025-10-01},

journal = {Int J Environ Res Public Health},

volume = {22},

number = {10},

abstract = {Prenatal physical activity (PA) has well-established benefits for maternal mental health. However, PA levels are generally low among pregnant individuals and were even lower during the COVID-19 pandemic. Since walking is the most popular form of prenatal PA, we aimed to examine associations between walking in the third trimester of pregnancy and mental health symptoms of depression, anxiety, pregnancy-related anxiety and perceived stress during the pandemic. Relevant pandemic-related factors (e.g., COVID-19 waves, population density) associated with walking were also studied. Pregnant individuals were recruited across Quebec (Canada) between October 2020 and September 2022, as part of the Resilience and Perinatal Stress during the Pandemic (RESPPA) study. Analyses were conducted on data collected via online questionnaires during the third trimester ( = 1086). Results revealed that higher levels of walking were significantly associated with lower symptoms of generalized anxiety (β = -0.06,  = 0.035), and perceived stress (β = -0.07,  = 0.007). Living in a more densely populated area, living with fewer children at home and having a university degree were associated with higher levels of walking. Those who completed their questionnaire in the second pandemic wave also reported higher levels of walking. Our results highlight the potential of walking in the third trimester to support maternal mental health.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid41259377,

title = {Birth weight discordance, gene expression, and DNA methylation: A scoping review of epigenetic twin studies},

author = {Dany Laure Wadji and Zsofia Nemoda and Chantal Martin-Soelch and Linda Booij and Chantal Wicky},

doi = {10.1371/journal.pone.0315549},

issn = {1932-6203},

year  = {2025},

date = {2025-01-01},

journal = {PLoS One},

volume = {20},

number = {11},

pages = {e0315549},

abstract = {BACKGROUND: Birth weight is considered as an important indicator of environmental conditions during prenatal development. Molecular mechanisms, including epigenetic modifications, play central roles in the body's adaptation to ever-changing environmental conditions. Twin study designs offer a powerful approach for distinguishing environmental from genetic effects. Specifically, within-pair comparisons of monozygotic twins can be used to differentiate unique individual environmental factors from shared environmental and genetic contributions. Notably, numerous studies in monozygotic twins have shown associations between prenatal environment and birth weight discordance (BWD), and suggested a potential involvement of gene expression and epigenetic factors mediating the association.nnOBJECTIVE: To conduct a scoping review of the literature on definitions of BWD and on epigenetic modifications and gene expression changes associated with BWD in twins.nnMETHOD: Following PRISMA guidelines, we searched PubMed and Ovid MEDLINE(R) databases and included 34 twin studies focusing on birth weight and epigenetic or gene expression outcomes.nnRESULTS: There is a lack of consensus on BWD values when comparing groups of twins for their risks of perinatal mortality and morbidity, which vary between 15-30% depending on the type of placentation and gestational age. The gene expression twin studies measured mostly metabolism-related candidate genes in placental tissues. Only small-scale twin studies measured BWD associated with gene expression patterns on genome-wide level using neonatal cells. Most DNA methylation twin studies conducted epigenome-level analyses, and studies differ substantially in terms of tissue type and age of the children. Differences in DNA methylation patterns measured in blood or saliva samples of the twins later in life were mostly in genes related to signal transduction, cell differentiation and proliferation processes.nnCONCLUSION: Transcriptional changes of placental glucose transporters and hypoxia-induced proteins possibly reflect compensatory processes in twin pregnancies. Gene ontology analysis of the differentially methylated genes associated with BWD pointed to transcription regulation and tissue development.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40037661,

title = {Elevated plasma B and betaine levels in women with anorexia nervosa: possible role in illness pathophysiology and epigenetic regulation},

author = {Howard Steiger and Kevin F Casey and Jessica Burdo and Valerie Marcil and Maegan Harvison and Juliana Meyerfreund and Édith Breton and Zsofia Nemoda and Lea Thaler and Annie St-Hilaire and Mimi Israel and Chloe Paquin-Hodge and Luis B Agellon and Véronique Bélanger and Linda Booij},

doi = {10.1503/jpn.240155},

issn = {1488-2434},

year  = {2025},

date = {2025-01-01},

journal = {J Psychiatry Neurosci},

volume = {50},

number = {2},

pages = {E85--E91},

abstract = {BACKGROUND: Phenomenology in anorexia nervosa (AN) appears to be subject to epigenetic regulation via DNA methylation. The micronutrients B and betaine contribute directly to DNA methylation and have been shown to be abnormally elevated in blood samples from people with AN.nnMETHODS: We measured plasma B and betaine levels, as well as leukocyte DNA methylation levels, among women with active AN (AN-active group), those in 1-year remission from AN (AN-remitted group), and those who had never experienced an eating disorder (NED group). We compared the groups on micronutrient levels and on the strength of association between micronutrients and methylation.nnRESULTS: We included 64 women in the AN-active group, 49 in the AN-remitted group, and 49 in the NED group. Relative to those with NED (B: mean 339.6 [standard deviation (SD) 224.3] μmol/L; betaine: mean 33.74 [SD 17.10] μmol/L), participants with active AN showed high B and betaine (B: mean 571.0 [SD 505.2] μmol/L; betaine: mean 43.73 [SD 22.50] μmol/L); AN-remitted participants had elevated B alone (B: mean 588.2 [SD 379.9] μmol/L; betaine: mean 33.50 [SD 19.20] μmol/L). There were also group-based differences in the strength of association between B and site-specific DNA methylation at genes regulating insulin function, glucose metabolism, cell regulation, and neurotransmitter function. These associations between B and methylation levels were generally stronger among those without an ED than among those with either active or remitted AN.nnLIMITATIONS: The extent to which plasma nutrient levels provide a meaningful proxy to cellular processes affecting DNA methylation is uncertain and the sample size limits the stability of results. We included only biological females in this investigation.nnCONCLUSION: Elevated B levels in AN resemble elevations reported among people with autoimmune, neoplastic, or other disorders. Such elevations imply that plasma B levels may misrepresent nutritional status among people with AN. Observed associations between levels of B and methylation at certain gene regions have ambiguous importance, but may indicate an influence of nutritional status on epigenetic mechanisms or may be the coincidence of separate processes that independently affect levels of micronutrients and DNA methylation.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39548958,

title = {Examining Dimensionality and Item-Quality of the Eating Disorder Examination Questionnaire in Individuals With Eating Disorders Using Item Response Theory Analysis},

author = {Rachel Dufour and Howard Steiger and Linda Booij},

doi = {10.1002/eat.24330},

issn = {1098-108X},

year  = {2024},

date = {2024-11-01},

journal = {Int J Eat Disord},

abstract = {OBJECTIVE: The Eating Disorder Examination Questionnaire (EDE-Q) is a widely-used measure of eating-disorder symptoms. However, inconsistent replication of the subscale structure raises concern about validity. To provide a rigorous test of the EDE-Q's dimensionality and item-quality, we applied modern and classical test theory approaches to data obtained from a large, transdiagnostic sample of people with clinical eating disorders.nnMETHOD: We analyzed data from 1197 individuals (M = 27.9 years, SD = 10.08, 95% female) with various eating disorders, who had been assessed for treatment at a specialized program. Exploratory analyses (including Parallel Analyses), Confirmatory Factor Analyses (CFA) and graded-response Item Response Theory (IRT) analyses, were conducted with Mplus.nnRESULTS: Factor analyses showed inappropriate fit to the original EDE-Q subscales, as well as for alternative 1,2,3, and 4-factor solutions. Parallel analyses suggested a one-dimensional structure as best fit. IRT analyses showed substantial variability in EDE-Q-item quality and indicated that five items (fear of weight gain, feeling fat, desire to lose weight, importance of weight, importance of shape) were most pertinent to determining severity. The construct validity of the five EDE-Q items was confirmed by a CFA, showing excellent fit.nnDISCUSSION: Our results suggest that EDE-Q scores are best interpreted as spanning a one-factor continuum. IRT results suggest that some items are more pertinent than others for determining eating-disorder severity. Results could be useful for establishing short EDE-Q versions, such as a five-item version, which, in turn, would be helpful for measurement-based clinical practice and for data-collection in epidemiological and experimental studies.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38997243,

title = {Outcomes of a Virtual Day Treatment Program for Adults With Eating Disorders-Comparison With In-Person Day Treatment},

author = {Lea Thaler and Linda Booij and Annie St-Hilaire and Chloé Paquin-Hodge and Nesrine Mesli and Hope Burko and Viveca Lee and Stephanie Oliverio and Mimi Israël and Howard Steiger},

doi = {10.1002/eat.24263},

issn = {1098-108X},

year  = {2024},

date = {2024-10-01},

journal = {Int J Eat Disord},

volume = {57},

number = {10},

pages = {2135--2140},

abstract = {OBJECTIVE: Previous studies have indicated that virtual treatments for eating disorders (EDs) are roughly as effective as are in-person treatments; the present nonrandomized study aimed to expand on the current body of evidence by comparing outcomes from a virtual day treatment program with those of an in-person program in an adult ED sample.nnMETHOD: Participants were 109 patients who completed at least 60% of day treatment sessions (n = 55 in-person and n = 54 virtual). Outcome measures included ED and comorbid symptoms, and motivation.nnRESULTS: Linear mixed models showed that global EDE-Q scores decreased during treatment (AIC = 376.396, F = 10.94, p = 0.002), irrespective of treatment modality (p = 0.186). BMI significantly increased over time (AIC = 389.029, F = 27.97, p < 0.001), with no effect of treatment modality (p = 0.779).nnDISCUSSION: Our findings suggest that the virtual delivery of day treatments produces comparable outcomes to those obtained using in-person formats, and that virtual formats may represent a pragmatic treatment option, especially in situations in which access to in-person care is limited.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37644511,

title = {Development of a transdiagnostic digital interactive application for eating disorders: psychometric properties, satisfaction, and perceptions on implementation in clinical practice},

author = {Linda Booij and Mimi Israël and Manuela Ferrari and Annie St-Hilaire and Chloé Paquin-Hodge and Melissa Allard and Amélie Blaquière and Julia Dornik and Shiri Freiwald and Shawna A Long and Marika Monarque and William D Pelletier and Lea Thaler and Miriam Yaffe and Howard Steiger},

doi = {10.1186/s40337-023-00871-3},

issn = {2050-2974},

year  = {2023},

date = {2023-08-01},

journal = {J Eat Disord},

volume = {11},

number = {1},

pages = {146},

abstract = {BACKGROUND: Given limited availability of informed treatments for people affected by eating disorders (EDs), there has been increasing interest in developing self-administered, technology-based ED interventions. However, many available interventions are limited to a specific ED diagnosis or assume that participants are ready to change. We developed a digital self-help application (called ASTrA) that was explicitly designed to be transdiagnostic and to help increase motivation for change. The aim of the present study was to describe the development and examine the psychometric properties, user satisfaction and rated potentials for practical use of our application.nnMETHODS: The content of our application was based on concepts derived from self-determination theory, the transtheoretical model of change, and cognitive theory. The application was developed by a multidisciplinary team of clinicians, researchers, staff members and individuals with lived ED experience, each being involved in all steps of the application's development. We tested validity, reliability, satisfaction and perceived feasibility for clinical implementation in an independent sample of 15 patients with an ED and 13 clinicians specialized in ED treatment. Psychometric properties were evaluated using descriptive statistics, correlations, content validity indices and intraclass coefficients. Differences in satisfaction ratings and perceived potential for clinical implementation of the application between clinicians and patients were examined using Mann-Whitney U tests.nnRESULTS: The digital application showed excellent validity (mean i-CVI: .93, range: .86-.96) and internal reliability (all Cronbach alpha's > .88). Patients and clinicians both considered the application acceptable, appropriate, and feasible for use in clinical practice.nnCONCLUSIONS: Findings suggest that our transdiagnostic interactive application has excellent psychometric properties. Furthermore, patients and clinicians alike were positive about the possible use of the application in clinical practice. The next step will be to investigate the application's effectiveness as an intervention to promote autonomous motivation and to facilitate remission in people on the waitlist for specialized ED treatment.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35703085,

title = {DNA methylation in people with anorexia nervosa: Epigenome-wide patterns in actively ill, long-term remitted, and healthy-eater women},

author = {Howard Steiger and Linda Booij and Lea Thaler and Annie St-Hilaire and Mimi Israël and Kevin F Casey and Stephanie Oliverio and Olivia Crescenzi and Viveca Lee and Gustavo Turecki and Ridha Joober and Moshe Szyf and Édith Breton},

doi = {10.1080/15622975.2022.2089731},

issn = {1814-1412},

year  = {2023},

date = {2023-03-01},

journal = {World J Biol Psychiatry},

volume = {24},

number = {3},

pages = {254--259},

abstract = {OBJECTIVES: Recent studies have reported altered methylation levels at disorder-relevant DNA sites in people who are ill with Anorexia Nervosa (AN) compared to findings in people with no eating disorder (ED) or in whom AN has remitted. The preceding implies state-related influences upon gene expression in people with AN. This study further examined this notion.nnMETHODS: We measured genome-wide DNA methylation in 145 women with active AN, 49 showing stable one-year remission of AN, and 64 with no ED.nnRESULTS: Comparisons revealed 205 differentially methylated sites between active and no ED groups, and 162 differentially methylated sites between active and remitted groups ( < 0.01). Probes tended to map onto genes relevant to psychiatric, metabolic and immune functions. Notably, several of the genes identified here as being differentially methylated in people with AN (e.g. , , ) have figured in previous studies on AN. Effects also associated illness chronicity and lower BMI with more pronounced DNA methylation alterations, and remission of AN with normalisation of DNA methylation.nnCONCLUSIONS: Findings corroborate earlier results suggesting reversible DNA methylation alterations in AN, and point to particular genes at which epigenetic mechanisms may act to shape AN phenomenology.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36482144,

title = {Pathways of association between disordered eating in adolescence and mental health outcomes in young adulthood during the COVID-19 pandemic},

author = {Tianna Loose and Marie Claude Geoffroy and Massimiliano Orri and Nicholas Chadi and Sara Scardera and Linda Booij and Edith Breton and Richard Tremblay and Michel Boivin and Sylvana Coté},

doi = {10.17269/s41997-022-00715-8},

issn = {1920-7476},

year  = {2023},

date = {2023-02-01},

journal = {Can J Public Health},

volume = {114},

number = {1},

pages = {22--32},

abstract = {OBJECTIVES: The COVID-19 pandemic has been associated with increased mental health problems. We investigated (1) associations between disordered eating in adolescence and mental health problems after one year of the pandemic and (2) the mechanisms explaining associations.nnMETHOD: We analyzed data from a population-based birth cohort in Quebec, Canada (557 males and 759 females). High and low levels of disordered eating symptom trajectories were previously estimated (age 12, 15, 17, and 20 years). Anxiety, depression, non-suicidal self-injury, and suicidal ideation were assessed at 23 years (March-June 2021). Putative mediators included loneliness and social media use (age 22 years, July-August 2020). Analyses controlled for mental health and socio-economic status at age 10-12 years and were conducted for males and females separately.nnRESULTS: Females in the high-level disordered eating symptom trajectory were at increased risk for non-suicidal self-injury (OR 1.60; 95% CI 1.02-2.52) and suicidal ideation (2.16; 1.31-3.57), whereas males were at increased risk for severe anxiety (2.49; CI 1.11-5.58). Males and females in the high-level trajectory were more likely to report severe depression (2.26; 1.14-5.92 and 2.15, 1.36-3.38 respectively). Among females, associations were partially explained (17-35%) by loneliness during the first 4 months of the pandemic.nnCONCLUSION: Young adults who experienced disordered eating as adolescents were at increased risk of mental health problems during the pandemic. Loneliness partially mediated the effect, suggesting that pandemic mitigation resulting in increased social isolation may have exacerbated mental health problems among women with a history of disordered eating.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34971014,

title = {Predictors of non-completion of a day treatment program for adults with eating disorders},

author = {Lea Thaler and Linda Booij and Nuala Burnham and Samantha Kenny and Stephanie Oliverio and Mimi Israel and Howard Steiger},

doi = {10.1002/erv.2879},

issn = {1099-0968},

year  = {2022},

date = {2022-03-01},

journal = {Eur Eat Disord Rev},

volume = {30},

number = {2},

pages = {146--155},

abstract = {Although treatment dropout is common among patients with eating disorders, very few studies have examined predictors of non-completion in day treatment. We investigated various potential predictors of dropout from adult day treatment. Participants were 295 adult patients with a diagnosis of Anorexia Nervosa (restricting or binge-eating/purging subtype), Bulimia Nervosa (BN), Other Specified Feeding or Eating Disorder, or Avoidant Restrictive Food Intake Disorder. Predictors included eating-disorder characteristics, motivation at the commencement of treatment, Body Mass Index (BMI), time spent in treatment and personality dimensions. Logistic regression analyses showed that for patients with a BMI of less than 20 at the start of treatment, low BMI was a significant predictor of staff-initiated termination due to not meeting weight gain goals. Furthermore, completing less than 6 weeks of treatment was associated with staff-initiated termination. For the whole sample, those with higher changes in weight over the course of treatment were less likely to terminate prematurely. None of the other predictor variables yielded significant results. Results of the current study highlight characteristics of patients who are more likely not to complete day treatment and can help identify patients who may be at risk for not succeeding in multi-diagnostic day treatment programs.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34904742,

title = {In-person versus virtual therapy in outpatient eating-disorder treatment: A COVID-19 inspired study},

author = {Howard Steiger and Linda Booij and Olivia Crescenzi and Stephanie Oliverio and Ilana Singer and Lea Thaler and Annie St-Hilaire and Mimi Israel},

doi = {10.1002/eat.23655},

issn = {1098-108X},

year  = {2022},

date = {2022-01-01},

journal = {Int J Eat Disord},

volume = {55},

number = {1},

pages = {145--150},

abstract = {OBJECTIVE: Findings show virtual therapy (conducted using internet-based videoconferencing techniques) to be a viable alternative to in-person therapy for a variety of mental-health problems. COVID-19 social-distancing imperatives required us to substitute virtual interventions for in-person sessions routinely offered in our outpatient eating disorder (ED) program-and afforded us an opportunity to compare the two treatment formats for clinical efficacy.nnMETHODS: Using self-report assessments, we compared outcomes in a historical sample of 49 adults with heterogeneous EDs (treated in-person over 10-14 weeks in individual and group therapies) to those of 76 patients receiving comparable virtual treatments, at distance, during the COVID-19 outbreak. Linear mixed models were used to study symptom changes over time and to test for differential effects of treatment modality.nnRESULTS: Participants in both groups showed similar improvements on eating symptoms, levels of weight gain (in individuals in whom gain was indicated), and satisfaction with services.nnDISCUSSION: Our results suggest that short-term clinical outcomes with virtual and in-person ED therapies are comparable, and point to potentials of virtual therapy for situations in which geographical distance or other barriers impede physical access to trained therapists or specialized treatments.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid32954512,

title = {Pretreatment motivation and therapy outcomes in eating disorders: A systematic review and meta-analysis},

author = {Jeanne Sansfaçon and Linda Booij and Lise Gauvin and Émilie Fletcher and Farah Islam and Mimi Israël and Howard Steiger},

doi = {10.1002/eat.23376},

issn = {1098-108X},

year  = {2020},

date = {2020-12-01},

journal = {Int J Eat Disord},

volume = {53},

number = {12},

pages = {1879--1900},

abstract = {OBJECTIVE: Identifying modifiable predictors of outcomes following treatment for eating disorders may help to tailor interventions to patients' individual needs, improve treatment efficacy, and develop new interventions. The goal of this meta-analysis was to quantify the association between pretreatment motivation and posttreatment changes in eating disorder symptomology.nnMETHOD: We reviewed 196 longitudinal studies reporting on change on indices of overall eating-disorder symptomatology, weight gain, binge-eating, vomiting, anxiety/depression, and treatment adherence. Meta-analyses were performed using two complementary approaches: (a) combined probability analysis using the added Z's method; (b) effect size analyses. Using random-effect models, effect sizes were pooled when there were at least three studies with the same type of statistical design and reporting statistics on the same outcome. Heterogeneity in study outcome was evaluated using Q and I statistics. Studies were reviewed qualitatively when the number of studies or reported data were insufficient to perform a meta-analysis.nnRESULTS: Forty-two articles were included. Although samples and treatments differed substantially across studies, results across studies were remarkably consistent. Both combined-probability and effect-size analyses indicated positive effects of pretreatment motivation on improvement in general eating-disorder symptoms (Cohen's r = .17), and an absence of effects on anxiety/depression symptoms. Remaining outcome indices were subject to selective reporting and/or small sample size bias.nnDISCUSSION: Our findings underscore the importance of incorporating treatment engagement approaches in the treatment of eating disorders. Optimal reporting of study findings and improving study quality would improve future efforts to obtain an in-depth understanding of the relationship between motivation and eating disorder symptoms.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid32576735,

title = {Applying epigenetic science to the understanding of eating disorders: a promising paradigm for research and practice},

author = {Linda Booij and Howard Steiger},

doi = {10.1097/YCO.0000000000000632},

issn = {1473-6578},

year  = {2020},

date = {2020-11-01},

journal = {Curr Opin Psychiatry},

volume = {33},

number = {6},

pages = {515--520},

abstract = {PURPOSE OF REVIEW: Studies indicate that environmental factors, acting at various moments throughout the life cycle, can result in epigenetically mediated alterations in gene expression. In this article, we review recent findings on the role of epigenetic factors in eating disorders, address methodological issues that need to be considered when interpreting research findings, and comment on possible clinical applications.nnRECENT FINDINGS: Evidence suggests that eating disorders implicate alterations of methylation in genes involved in the mental status, metabolism, anthropometric features and immunity. Furthermore, some research in individuals with anorexia nervosa suggests the presence of reversible, malnutrition-induced epigenetic alterations that 'reset' as patients recover.nnSUMMARY: Epigenetic studies in the eating disorders corroborate the idea that eating disorder cause is multifactorial, and identify markers that could help inform our understanding of illness staging and subtyping that may explain the commonly progressive course of these disorders, and that may provide insights towards the development of novel interventions. Already, there is evidence to suggest that, in people with eating disorders, epigenetically informed interventions help reduce stigma and shame, and increase self-acceptance and hopes of recovery. Although findings are intriguing, further research is required as, to date, studies apply modest sample sizes and disparate methodologies.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}