Publications by authors named "Andrea Goldschmidt"

Objective: Partial remission from anorexia nervosa (AN) is an understudied stage of illness, during which individuals experience improvements in behavioral/physical symptoms, but continue to experience cognitive/affective symptoms. Studying factors that may be related to recovery vs. relapse during partial remission is important given the relatively low rates of full remission in AN.

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Background: Pain after childbirth affects maternal and infant outcomes. Although sleep influences pain in general adult populations, research on this during the perinatal period is limited. This study examines the association between sleep quality and duration changes from mid to late pregnancy and pain during postpartum hospitalization.

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Objective: Since its publication almost 35 years ago, the Eating Disorder Examination (EDE) and its companion paper-and-pencil self-report-the Eating Disorder Examination-Questionnaire (EDE-Q)-have remained some of the most widely used and studied tools for the assessment of eating disorder symptoms. Widespread use of the EDE has persisted despite notable limitations of the measure, while other assessment tools developed in the decades since have been inconsistently adopted, both of which may have consequences for accumulation and replication of knowledge within the field.

Method: In the current forum, we propose that common critiques of the EDE are representative of larger issues that face the subfield of ED assessment.

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Objective: Dysregulated eating is common among youth and is associated with trait-level negative affect and emotion regulation difficulties. Despite the transient nature of affect, momentary associations among affect and eating behavior are unclear, which limits development of more impactful treatment tools, such as "just-in-time" intervention approaches (JITAI). The current study (N = 62) drew from two ecological momentary assessment (EMA) studies involving children and adolescents who endorsed loss of control (LOC) eating symptoms during a two-week assessment period.

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Translational research applies laboratory-generated scientific discoveries to real-world practice with the goal of potentiating more rapid solutions to health challenges. In 2023, the authors of this editorial (Hildebrandt and Goldschmidt) aimed to develop a special issue for the International Journal of Eating Disorders (IJED) focusing on translational eating disorder research. The goal for this issue was to begin closing the gap between basic and applied research by soliciting articles that improve our understanding of mechanisms that cause or maintain eating disorders, which could result in more robust research advances and dissemination of information to the public.

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Article Synopsis
  • - Cognitive-behavioral therapy (CBT) is used to treat binge-eating disorder (BED) in adolescents, but executive dysfunction may hinder its effectiveness by affecting engagement with the treatment and ability to apply learned strategies in everyday life.
  • - A study involving 73 adolescents revealed that impulsive decision-making was linked to better attendance and more frequent loss of control eating, while low cognitive flexibility predicted higher body weight after treatment.
  • - The results suggest that improving executive functioning could enhance treatment outcomes for adolescents with BED, though further research is needed due to the small sample size and specific study design.
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Background: Recent pediatric guidelines recommend clinicians offer anti-obesity medication (AOM) as an adjunct to intensive lifestyle intervention.

Objective: To investigate pediatricians' perspectives about prescribing AOM, including barriers and facilitators.

Methods: An investigator-developed survey was emailed to primary care pediatric physicians (n = 187) and advanced practice providers (n = 190) within an academic-affiliated network.

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Background: Family-based treatment (FBT) is a front-line empirically supported intervention for adolescent anorexia nervosa, but it is often inaccessible to families from lower income backgrounds, as it is most typically available in specialty research and private practice settings. In preparation for a pilot trial of FBT delivered in the home setting, this study qualitatively examined provider perceptions of implementing FBT in lower-income communities.

Methods: Eating disorder clinicians working in community clinics (therapists, medical doctors, dietitians, and social workers; n = 9) were interviewed about their experiences using FBT.

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Purpose Of Review: The present review describes the recent literature on treatment for binge-eating disorder (BED) in adults and youth, with a particular focus on research gaps, emerging treatments, and future research directions.

Recent Findings: Evidence supports the efficacy of several treatment modalities in adults, including self-help treatment, clinician-led psychotherapy, and pharmacotherapy; the largest effect sizes have been found for psychotherapies, most of which were cognitive-behavioral in orientation. Adapted psychotherapies for youth also show promise but lack a robust body of evidence.

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Objective: Parents' negative body talk about children (negative weight/shape comments) and internalized weight bias (application of negative weight-based stereotypes to oneself) are associated with children's maladaptive eating behaviors, but mechanisms are poorly understood. Conceptually, parental behaviors and attitudes may translate to implicit and explicit concerns about their child's weight and influence parents' feeding practices. These associations are underexplored in the literature.

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National estimates suggest that more than 35% of American children, ages 2-19 years, are overweight or obese, which increases their risk for weight-related comorbidities including diabetes, cancer, cardiovascular disease risk factors, depression, and anxiety. While obesity prevention is most cost-effective, for youth with existing obesity, the United States Preventive Services Task Force recommends ≥26 h of comprehensive lifestyle intervention over 6-12 months. This include standard behavioral therapy, dietary counseling, and an emphasis on physical activity.

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Background: This study describes the prevalence of hypophosphatemia, hypokalemia, and/or hypomagnesemia and resulting electrolyte supplementation during refeeding in severely malnourished youths hospitalized for restrictive eating disorders.

Methods: Hospitalized patients between 11-26y (N = 81) at < 75% treatment goal weight (TGW) were assessed through retrospective chart review. Outcomes were compared between participants < 70% TGW and those 70-75% TGW.

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Background: Children with loss of control (LOC) eating and overweight/obesity have relative deficiencies in trait-level working memory (WM), which may limit adaptive responding to intra- and extra-personal cues related to eating. Understanding of how WM performance relates to eating behavior in real-time is currently limited.

Methods: We studied 32 youth (ages 10-17 years) with LOC eating and overweight/obesity (LOC-OW; n = 9), overweight/obesity only (OW; n = 16), and non-overweight status (NW; n = 7).

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Background: Anorexia nervosa (AN) is a serious mental illness associated with high rates of morbidity and mortality. Family-based treatment (FBT) is a well-established treatment for adolescent AN, yet it is underutilized in community settings and is unavailable to many families, particularly those from lower income and racial and ethnic minority backgrounds. Furthermore, some families do not respond optimally to FBT, possibly because of challenges translating skills acquired in office-based treatment settings to naturalistic settings.

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The Eating Disorders In weight-related Therapy (EDIT) Collaboration brings together data from randomised controlled trials of behavioural weight management interventions to identify individual participant risk factors and intervention strategies that contribute to eating disorder risk. We present a protocol for a systematic review and individual participant data (IPD) meta-analysis which aims to identify participants at risk of developing eating disorders, or related symptoms, during or after weight management interventions conducted in adolescents or adults with overweight or obesity. We systematically searched four databases up to March 2022 and clinical trials registries to May 2022 to identify randomised controlled trials of weight management interventions conducted in adolescents or adults with overweight or obesity that measured eating disorder risk at pre- and post-intervention or follow-up.

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A bidirectional association between shape and weight concerns (SWC) and physical activity (PA) has been previously documented. This relationship may be particularly salient among youth with overweight/obesity, given that social marginalization of larger bodies has been associated with elevated SWC and barriers to PA. This pilot study explores reciprocal relationships between momentary SWC and accelerometer-assessed PA behavior.

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Eating disorders (EDs) present high costs to the individual and society, and need for services far surpasses their availability. Caregivers are often on the "front lines" of managing their child's illness yet may have very little support to sustain them in this role. It is well-established that caregiver burden related to EDs is high, although most research has focused on caregivers of adult patients.

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Importance: Lifestyle change is central to diabetes risk reduction in youth with overweight or obesity. Feeling susceptible to a health threat can be motivational in adults.

Objective: To evaluate associations between diabetes risk perception and/or awareness and health behaviors in youth.

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Background: Adolescent-onset type 2 diabetes (T2D) is a major public health concern of growing proportions. Prevention, therefore, is critical. Unfortunately, standard-of-care treatment for T2D prevention (e.

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Objective: Family-based treatment (FBT) is a well-established intervention for adolescent anorexia nervosa (AN). Although FBT is efficacious in promoting weight gain and improvements in psychological symptoms, for some adolescents, cognitive/attitudinal recovery lags behind weight gain. This study conducted an exploratory post hoc analysis of outcomes of adolescents who achieved weight gain by the end of FBT but continued to experience elevated psychological symptoms post-treatment.

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Objective: Loss-of-control (LOC) eating is common in adults undergoing bariatric surgery. Agreement between real-time and retrospective assessment methods is unclear.

Methods: Adults with severe obesity reported on LOC eating over the preceding 28 days via Eating Disorder Examination-Questionnaire (EDE-Q) items and in near real time over 10 days via ecological momentary assessment (EMA; involving daily repeated surveys delivered via smartphone in the natural environment), with both assessment forms completed before surgery and at 3, 6, and 12 months after surgery.

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Objective: Although family-based treatment (FBT) is considered a first-line treatment for adolescent anorexia nervosa (AN), it is underutilized in community settings and is unavailable to many families for a multitude of practical reasons (e.g., costs of treatment, transportation constraints).

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Introduction: This study examined problematic eating and eating-related psychopathology among young adults who underwent adolescent bariatric surgery including concurrent and prospective associations with psychosocial factors and weight change.

Methods: VIEW point is a 6-year follow-up study within a prospective observational study series observing adolescents with severe obesity who had bariatric surgery ( = 139) or who presented to nonsurgical lifestyle modification programs ( = 83). Participants completed height/weight measurements, questionnaires, and diagnostic interviews.

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Article Synopsis
  • Study investigates how sleep duration affects the relationship between negative emotions and loss-of-control (LOC) eating in children with overweight/obesity.
  • Children aged 8-14 were monitored over two weeks for negative affect, LOC eating, and sleep patterns using assessment and diary tools.
  • Findings reveal that shorter sleep duration increases the likelihood of LOC eating following negative emotions, indicating a need for further research on sleep's role in emotion regulation and eating behaviors.
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Background: Research suggests that youth with overweight/obesity can be subtyped according to disinhibited eating tendencies. No research has attempted to subtype classes of eating episodes along sensational, psychological, and hedonic dimensions.

Methods: Youth (N = 39; 55% female) aged 8-14 y with overweight/obesity completed a 2-week ecological momentary assessment protocol in which they reported on all eating episodes and their sensational, environmental, affective, and interpersonal contexts.

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