ICED 2017

Poster Session II Abstracts

Friday 12:45-2:00PM
Congress Hall Foyer BC, second floor

F001: Short-term Treatment Outcomes and Dropout Risk in Males and Females with Eating Disorders

Zaida Aguera, PhD, University Hospital of Bellvitge- Idibell, Ciberobn, Hospitalet de Llobregat, Barcelona, Isabel Sánchez, PhD, University Hospital of Bellvitge - Idibell, Hospitalet de Llobregat, Barcelona, Roser Granero, PhD, Universitat Autònoma de Barcelona, Ciberobn, Barcelona, Barcelona, Nadine Riesco, PhD, University Hospital of Bellvitge - Idibell, Hospitalet de Llobregat, Barcelona, Trevor Steward, MSc, University Hospital of Bellvitge- Idibell, Ciberobn, Hospitalet de Llobregat, Barcelona, Virginia Martín-Romera, MSc, Universitat Autònoma de Barcelona, Barcelona, Barcelona, Susana Jiménez-Murcia, PhD, University Hospital of Bellvitge- Idibell, Ciberobn, Hospitalet de Llobregat, Barcelona, Jose M Menchón, PhD, University Hospital of Bellvitge-Idibell, Cibersam, Hospitalet de Llobregat, Barcelona, Fernando Fernández-Aranda, PhD, University Hospital of Bellvitge-Idibell, Ciberobn, Hospitalet de Llobregat, Barcelona

This study aimed to compare short-term treatment outcomes between males and females diagnosed with eating disorders. It also analyzed specific clinical predictors of remission and dropout in both sexes. The whole sample consisted of 131 male and 131 female eating disorder patients, matched for age and diagnosis. All patients were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. Assessment measures included the Eating Disorder Inventory-2, the Symptom Checklist-Revised and the Temperament and Character Inventory-Revised, as well as other clinical, motivational and psychopathological indices. All patients underwent the same cognitive-behavioral therapy treatment protocol (day hospital or outpatient group therapy, according to their diagnosis). After adjusting for eating disorder severity, our results suggest that both full remission and risk of dropout were higher for males than for females with eating disorders. Predictive models of treatment outcome indicated some shared factors associated with higher risk of dropout and lower risk of full remission, namely higher scores in novelty seeking. However, in men, younger age and lower levels in reward dependence also predicted higher dropout risk, while higher scores in persistence predicted achieve full remission. In conclusion, this study reinforces the effectiveness of using outpatient cognitive-behavioral therapy as treatment as usual for men with eating disorders. Nonetheless, placing greater emphasis on strategies targeting gender specific issues (namely motivation, stigma and some differential personality traits) could potentially enhance treatment adherence and outcomes.

F002: Food Choice Decision Making in Long-Term Weight Reduced Individuals

Laurel Mayer, MD, Columbia University Medical Center, New York, New York, Loren Gianini, PhD, Columbia University Medical Center, New York, New York, B. Timothy Walsh, MD, Columbia University Medical Center, New York, New York

There are striking parallels between the behavioral patterns of Long-term Weight Reduced individuals (LoWeR)(individuals who have lost a significant amount of weight (i.e., 30 pounds or more) and maintained this weight loss for a significant period of time (i.e., 12 months or longer)) and individuals with anorexia nervosa (AN) such as persistent adherence to a diet low in calories and fat and restricted in diet variety. Recently, results of a study in AN using a computerized food choice task wherein participants make choices between foods of varying caloric content have yielded important insights into potential neural mechanisms underlying this entrenched dietary practice. Our purpose was to examine whether this food choice task and subsequent ad libitum laboratory lunch meal might be able to similarly capture the dietary practices of LoWeR individuals. To date, we have recruited 10 LoWeR individuals. Mean BMI is 25.9 ±2.6 kg/m2, mean weight loss maintenance is 56.1 ± 30.3 lbs, and mean duration of weight loss maintenance is 4.4 ± 4.2 yrs. On the food choice task, LoWeR individuals chose high fat food items 28% of the time, compared to controls who chose high fat foods 40% of the time. Patients with AN chose high fat foods 18% of the time. In the lunch meal, LoWeR participants consumed an average of 660±282 kcals, with 25% ±13 of calories from fat. Most intriguingly, in this (and the AN) sample, proportion of high fat food choices on the food choice task was correlated with total caloric intake during the meal (r=.62, p=.056). Initial results suggest that this food choice task and meal procedure may be able to meaningfully capture the eating behavior of LoWeR participants and supports further exploration of the behaviors and potential neural mechanisms underlying food choice-decision making and the successful maintenance of a reduced weight.

F003: The Neural Bases of Maladaptive Coping Style in Eating Disorders

Tomomi Noda, MA, Kyoto University, Kyoto, Kyoto, Ema Murao, MD, Kyoto University, Kyoto, Kyoto, Michiko Kawabata, MS, Kyoto University, Kyoto, Kyoto, Masanori Isobe, MD; PhD, Kyoto University, Kyoto, Kyoto, Syun'ichi Noma, MD; PhD, Kyoto University, Kyoto, Kyoto

One of the characteristics of eating disorder patients is that they have maladaptive coping styles. Coping can be classified into approach and avoidant styles. Previous studies indicated that eating disorder patients tend to use avoidant-coping, which is considered maladaptive (Dyson and Renk, 2006), more compared with healthy controls (Troop et al., 1994), and that recovered eating disorder patients use approach-coping, which is considered adaptive (Haley et al., 1996), more compared with before recovery (Troop et al., 1997). Approach-coping requires self-regulatory control (Rueda et al., 2009). Patients with Binge-eating have deficient self-regulatory control, represented at the neural level by reduced prefrontal responses (Steinglass et al., 2009; Murphy et al., 2004). However, the neural bases of coping style in eating disorders have remained unclear. The purpose of the present study was to investigate the association between coping style and neural responses in prefrontal aria corresponding to behavioral inhibition using fMRI. The participants are 12 anorexia nervosa restrictive type (ANR), 12 anorexia nervosa binge/purge type, and 15 healthy controls (HC). fMRI data were acquired on a 3T MRI scanner using Go-NoGo task. To assess coping behavior, we used coping scale, COPE (Carver, 1989). The results showed that approach coping was significantly low in ANR and ANBP compared with HC. fMRI data analyses revealed that the activation of lateral orbit frontal cortex (OFC) was significantly higher in ANR compared with ANBP and HC. Behavioral data showed that the correct answer rate of Go-NoGo task was significantly low in ANBP compared with ANR and HC. Additionally, the activation of lateral OFC was significantly negatively correlated with the scores of approach coping (r =－.637, p ＞ 0.5) in ANBP. Lateral OFC is the region associated with response inhibition. Inhibition is considered as a paticulr features of making choices (Elliott et al., 2000) and it may be the critical region for maladaptive coping style in ANBP.

F004: An Open Series of Lamotrigine in Bulimia Nervosa and Anorexia Nervosa with Significant Affect Dysregulation and Poor Impulse Control

Tiffany Nakamura, MA, University of California, San Diego, San Diego, California, Mary Ellen Trunko, MD, University of California, San Diego, San Diego, California, Terry Schwartz, MD, University of California, San Diego, San Diego, California, Anne Cusack, PsyD, University of California, San Diego, San Diego, California, Laura Berner, PhD, University of California, San Diego, San Diego, California, Ursula Bailer, MD, Medical University of Vienna, Department of Psychiatry and Psychotherapy, Vienna, Waehringer Guertel, Joanna Chen, BS, University of California, San Diego, San Diego, California, Walter Kaye, MD, University of California, San Diego, San Diego, California 

Increasing evidence supports the role of pharmacotherapy, specifically mood stabilizers and selective serotonin reuptake inhibitors (SSRIs) producing short term reductions in symptoms of affective and behavioral dysregulation (ABD) and eating disorder behaviors. Additionally there is limited but promising evidence using lamotrigine as either an effective augmenting agent to SSRIs or as a monotherapy, showing significant reductions in affective dysregulation, impulsivity, and eating disorder symptomology. This open trial sought to evaluate the efficacy of Lamotrigine in 14 patients (mean age 28.2 years; SD = 7.6 years) all with comorbid ABD, impulsivity, and diagnoses of Bulimia Nervosa (BN) (N = 7), Anorexia Nervosa purging type (AN-P) (N= 3) and Anorexia Nervosa binge-purge type (AN-BP) (N = 4) in a university based partial hospitalization, intensive outpatient, and outpatient setting for the treatment of transdiagnostic eating disorders, utilizing dialectical behavior therapy (DBT) as the primary treatment modality. As such, the Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD), the Borderline Evaluation of Severity Over Time measure (BEST), and the Eating Disorder Examination Questionnaire (EDE-Q) were used to assess for changes in affective dysregulation and eating disorder symptomology change over time. Analyses with multilevel models indicate significant improvements in overall pathology as measured by the BEST (t = 4.01, p =0.015) and ZAN-BPD (t= 4.36, p=0.001) and eating disorder pathology with global EDE-Q at intake compared to discharge (t= 3.01, p=.009). There was significant reduction in severity across eating disorder diagnoses with increasing doses of lamotrigine and greater length of time on the medication. Additionally, medium-large reductions in scores on both measures (Cohen’s d = 0.57-1.94) were observed over 45 days. These findings strongly support the application of Lamotrigine in combination with DBT to both decrease ABD as well as eating disorder symptomology in both the short and long term.

F005: Posttraumatic Stress Disorder as a Predictor of Premature Termination of Day Hospital Treatment for Eating Disorders

WITHDRAWN

F006: Rumination in Patients with Binge-Eating Disorder and Obesity: Associations with Eating-Disorder Psychopathology and Weight Bias Internalization

Shirley Wang, Student, The College of New Jersey, New Haven, Connecticut, Janet Lydecker, PhD, Yale School of Medicine, New Haven, Connecticut, Carlos Grilo, PhD, Yale School of Medicine, New Haven, Connecticut

The presence of overvaluation of shape/weight in patients with binge-eating disorder (BED) and obesity is associated with greater eating-disorder (ED) psychopathology and greater likelihood of internalizing negative weight biases, which – in turn – are associated with poorer mental and physical health behaviors. Little is known, however, about other cognitive processes, such as rumination, that could contribute to either or both ED psychopathology and weight bias internalization. This study examined the significance of rumination, including brooding and reflective rumination, and overvaluation of shape/weight on ED psychopathology and weight bias internalization in a series of 237 treatment-seeking patients with comorbid BED and obesity. The Eating Disorder Examination interview assessed ED psychopathology; rumination and weight bias internalization were measured with established questionnaires. Rumination was significantly correlated with both ED psychopathology and weight bias internalization (p’s<.01). Hierarchical multiple regressions revealed that rumination was associated with ED psychopathology (ΔR2=.03, p=.01) and weight bias internalization (ΔR2=.18, p<.001) above and beyond overvaluation of shape/weight. Our findings suggest that, among patients with BED and obesity, rumination is an important cognitive process associated with severity of ED psychopathology. Importantly, the effects of rumination persisted after accounting for overvaluation of shape/weight. Because rumination involves a repetitive focus on distressing situations and thoughts, it is possible that patients characterized by higher levels of rumination are more likely to dwell on experiences with weight-based discrimination and internalize these negative attitudes. With additional controlled examination, findings that rumination plays a role in ED psychopathology and weight bias internalization could offer additional targets for treatment interventions.

F007: Peer Influence in Preadolescents and Adolescents: A Predictor for Body Dissatisfaction

Adriana Amaya-Hernández, PhD, Universidad Nacional Autónoma de México, México, Ciudad de Mexico, Juan Manuel Mancilla-Diaz, PhD, Universidad Nacional Autonoma de Mexico, Mexico, Ciudad de Mexico, Georgina Leticia Alvarez-Rayón, PhD, Universidad Nacional Autónoma de México, Mexico, Ciudad de Mexico, Mayaro Ortega-Luyando, PhD, Universidad Nacional Autónoma de México, Mexico, Ciudad de Mexico

It has been documented that disordered eating behaviors and body dissatisfaction have its occurrence peak during adolescence, also sociocultural factors, such as peer influence, have an impact on the presence of these; however, recent research has suggested that disordered eating behaviors and body dissatisfaction are present at a younger age. Therefore, the aims of this study were to compare disordered eating behavior, body dissatisfaction and peer influence between preadolescents and adolescents, and to analyze the role of peer influence in the development of disordered eating behaviors and body dissatisfaction. Two hundred seventy two preadolescents (135 women and 138 men) and 175 adolescents (95 women and 80 men) participated answering four questionnaires: Children Eating Attitudes Test, Body Shape Questionnaire, Sociocultural Attitudes Toward Appearance Questionnaire- Revised version, Inventory of Peer Influence on Eating Concerns, besides height and weight were obtained. As a first finding, statistical analysis showed significant differences in disordered eating behaviors, thin-ideal internalization, interaction with peers of the same sex and body mass index between groups, being preadolescents who obtained higher scores on these last three variables . Path analysis showed in both groups that body dissatisfaction was the predictor of disordered eating behaviors, while thin-ideal internalization and likability with peers of opposite sex had a direct effect on body dissatisfaction. With these models were explained 64% and 57% of the variance of body dissatisfaction and 27% and 40% of disordered eating behaviors for preadolescents and adolescents, respectively. These data support the hypothesis that from an early age can be observed disordered eating behaviors and discomfort with the body image. In addition to highlighting the role of peer influence as an important predictor of body image, so this kind of influence can be a key resource in social interventions aimed at increasing satisfaction with body image. This research was sponsored by PAPIIT IA-303616 and IN-306615.

F008: Examining Treatment Outcomes Comparing Eating Disordered Patients with and without Substance Use Disorder

Tamara Pryor, PhD; FAED Eating Disorder Center of Denver, Denver, Colorado, Ian Palombo, MA, Eating Disorder Center of Denver, Denver, Colorado, Charlee Borg, MA, University of Denver (DU), Denver, Colorado

Eating disorder and substance use disorders frequently co-occur but are rarely treated in a comprehensive integrated fashion. Studies suggest that patients that receive non-integrated services have poorer treatment outcomes. In an effort to create an integrated program that addresses both disorders we decided to first examine pre/post treatment data and compare our ED patients to our ED/SUD patients to measure if there are unique differences between groups that may inform specific treatment interventions. Archival data from an ED treatment facility was used. 77 women with comorbid eating disorder and substance abuse (ED/SUD) diagnoses were compared to 339 with eating disorder (ED) diagnoses only. Subjects' scores were compared on 3 scales from the Eating Disorder Inventory-3 (EDI-3) by group, and pre/post treatment. The scales were Interoceptive Deficits (ID), Perfectionism (Perf), and Emotional Dysregulation (EmD). Subjects were also compared on 4 scales of the Temperament Character Inventory (TCI) at admission. The scales were Novelty Seeking (NS), Harm Avoidance (HA), Persistence (P), and Self-Directedness (SD). All subjects benefited from treatment on the EDI-3 pre/post measures. However, upon discharge the ED/SUD group exhibited significantly higher scores on EmD than the ED only group when variances in baseline scores were controlled for. On the TCI, ED/SUD scored significantly higher on NS, and lower on P, and SD. As the ED field explores the treatment of comorbid SUD in ED treatment facilities, these results support approaches that focus on increase distress tolerance, developing coping skills for frustration and emotional regulation, addressing behavioral activation, as well as a focus upon increasing persistence, and enhancing self-directedness.

F009: Prevalence of Eating Disorders and Problem Eating Behaviors in Elderly Women

Eva Conceição, PhD, School of Psychology, University of Minho, Braga, Braga, Fabiana Gomes, MSc, School of Psychology, University of Minho, Braga, Braga, Ana Pinto-Bastos, MSc, School of Psychology, Universidade do Minho, Braga, Braga, Ana R. Vaz, PhD, School of Psychology, Universidade do Minho, Braga, Braga, Paulo P.P. Machado, PhD, School of Psychology, Universidade do Minho, Braga, Braga

The aim of this study is to examine the point prevalence of eating disorders and problem eating behaviors such as picking (or nibbling) in women aged 65 or over. This is a two stage epidemiological study that assessed 342 women aged between 65 and 94 years old. In Stage 1, screening measures used to identify possible cases were: Mini Mental State Examination – to screen and exclude patients with cognitive impairment; Weight Concerns Scale; SCOFF (Sick, Control, One, Fat, Food) - Questionnaire; Eating Disorder Examination – Questionnaire – dietary restraint subscale; three questions to screen for picking or nibbling and night eating syndrome. Women selected for Stage 2 (n=118) were interviewed with the diagnostic items of Eating Disorder Examination. According with DSM-5 the prevalence of eating disorders was 3.25% (1.83 – 5.7, 95% C.I.). Binge eating disorder was 1.68% (0.82 – 3.82, 95% C.I); other specified feeding or eating disorder 1.48% (0.63– 3.42, 95% C.I.); bulimia nervosa 0.3% (.05 – 1.7, 95% C.I.)]. Binge eating episodes were reported by 5.62% of women. No anorexia nervosa or night eating syndrome cases were identified. The prevalence of picking or nibbling was 18.9% and associated with increased body mass index (t(322)=-3.28, p<0.001). Eating disorders are rare but present problems in the elderly population, and picking or nibbling was the most frequently endorsed problem eating behavior. Considering the association of such problems with psychological, cognitive impairment, and weight management difficulties research is warranted to better explore such problems.

F010: Disordered Eating Behaviors: Two Decades of Study

Mayaro Ortega-Luyando, PhD, Universidad Nacional Autónoma de México, Mexico, Ciudad de México, Adriana Amaya-Hernandez, PhD, Universidad Nacional Autonoma de Mexico, Mexico, Ciudad de México, Georgina Alvarez-Rayon, PhD, Universidad Nacional Autonoma de Mexico, Mexico, Ciudad de Mexico, Juan Manuel Mancilla-Diaz, PhD, Universidad Nacional Autonoma de Mexico, Mexico, Ciudad de Mexico

International research suggests that disordered eating behaviors (DEB), have shown an increase over the years. However this has been a topic of constant debate since still there is not a consensus, not only for the scarcity of longitudinal studies, but also because from those longitudinal studies, few carry out trend analysis. To count with this kind of epidemiological data is relevant since this could enhance the effectiveness in planning health services, due to the designation of financial resources depends on the magnitude and frequency of the disease. Therefore, the objective of this study was to estimate the prevalence of DEB (diet, fasting, abuse of laxatives or diuretics, self-induced vomiting and binge eating) in Mexican university students over a 20-year period (1994-2013) divided into four cohorts. The sample was not randomize, consisting of 1250 women aged between 15 and 29 years old. Prevalence and trend analysis were performed. The results indicated that binge eating, dieting and fasting were the behaviors with highest prevalence, however the trend analysis showed a decrease over time (R²=0.83, R²=0.30 y R²=0.89, respectively). On the other hand self-induced vomiting and use of laxatives and diuretics showed lower prevalence rates and trend remained relatively stable over time (R²=0.05 y R²=0.04, respectively). Data showed that DEB trend in young Mexican women is not increasing over time as international studies report, these inconsistencies are discussed under a methodological and cultural perspective. Project sponsored by PAPIIT-IN306615, PAPIIT-IA303616

F011: Emotional Reactions to Binge Eating and Overeating: An Experience Sampling Study

Katrin Kukk, MA, University of Tartu, Tartu, Tartumaa, Kirsti Akkermann, PhD, University of Tartu, Tartu, Tartumaa

Eating behavior is influenced by many factors such as social and situational cues as well as emotions. Eating larger amounts of food in a brief period has been referred to as binge eating and overeating, the former accompanied by loss of control. It has been implied that binge eating and overeating may have different emotional effects since the presence of loss of control has been indicated as an important psychopathological determinant. The current study investigated the emotions accompanying binge eating, overeating healthy eating episodes using the Experience Sampling Method (ESM). 97 women and 61 men with a mean age of 22.3, answered a short questionnaire regarding their emotions and eating behavior on a palmtop computer 7 times a day during a three-day period. Among women, binge eating and overeating episodes differed significantly in subsequent sadness, shame, guilt, satisfaction, confidence, anxiousness, disappointment, loneliness, tedium, joy and motivation. The latter two had lower and other emotions had higher levels in the occasion of binge eating. Comparing binge eating episodes with healthy eating episodes differences appeared in subsequent sadness, shame, guilt, loneliness, and disappointment. Among men differences between binge eating and overeating episodes appeared only in the levels of joy. Binge eating episodes and healthy eating episodes differed significantly in the level of satisfaction and confidence, both of the emotions had lower levels in the presence of binge eating. The results indicate that binge eating and overeating may affect emotions differently. Also, women seem to be more sensitive to binge eating and overeating as they have more negative emotions following excessive eating.

F012: The Prevention of Eating Disorders and Obesity: Long-term Effects of School-based Programs in Germany

Felicitas Richter, MSc, Insitute for Psychosocial Medicine and Psychotherapy, Jena, Thuringia, Luise Adametz, MSc, Institute for Psychosocial Medicine and Psychotherapy, Jena, Thuringia, Julia Muehleck, MSc, Institute for Psychosocial Medicine and Psychotherapy, Jena, Thuringia, Katharina Wick, DiplPsych; PhD, Institute for Psychosocial Medicine and Psychotherapy, Jena, Thuringia, Bernhard Strauss, DiplPsych; PhD; Prof., Institute for Psychosocial Medicine and Psychotherapy, Jena, Thuringia, Uwe Berger, DiplPsych; PhD, Institute for Psychosocial Medicine and Psychotherapy, Jena, Thuringia

Eating disorders are difficult to treat and produce high treatment costs. Consequently, a number of universal and selective prevention programs were developed and evaluated in different countries in the past decade. The following research aims to summarize the evidence of the short- and long-term effects of the school-based prevention programs “PriMa” for preadolescent girls and “Torera” for preadolescent girls and boys in Germany. Two consecutive projects were conducted to evaluate the prevention programs comprehensively according to the standards of the Society for Prevention Research. The efficacy trial was conducted between 2004 and 2006 followed by the effectiveness evaluation in 2007-2008 and 2016. The examination of the broad dissemination completed the evaluation in 2016. A combination of quantitative and qualitative approaches was used in the data analysis. Long-term effects were examined in different trials combining self-report data of girls (N=100), secondary health insurance data (N=14.931), and qualitative teacher interviews (N=12). Results showed that body self-esteem as a key protective factor could be strengthened from early adolescence to young adulthood. In disordered eating, no group differences were obtained. Risk-group members as well as pupils, who participated in two programs instead of just one, benefited the most. To gain a more detailed understanding of the effects, it was examined whether program participation led to a decreased utilization of health care services concerning eating problems in the long-term. Concerning the broad dissemination of the prevention programs, challenging factors were a lack of the individual teacher’s interest, organizational barriers, and missing structural support via school administrations and political decision makers. A prevention strategy identifying possible ways into sustainable prevention dissemination will be introduced. This strategy may also serve as a model for health promotion in different areas.

F013: Yoga as an Adjunct to Intensive Eating Disorder Treatment: A Randomized Comparison

Traci McFarlane, PhD, Eating Disorder Program, University Health Network, Toronto General Hospital, Toronto, Ontario, Kelli Young, MEd, BScOT, Eating Disorder Program, University Health Network, Toronto General Hospital, Toronto, Ontario, Anne Marie Smith, MSW, Eating Disorder Program, University Health Network, Toronto General Hospital, Toronto, Ontario, Patricia Colton, MD; FRCPC, Eating Disorder Program, University Health Network, Toronto General Hospital, Toronto, Ontario

There is very little research in the area of yoga and disturbed eating/body image. Of the three randomized studies available in the literature, only one included participants with diagnosed eating disorders (ED). This study demonstrated that yoga led to decreases in weight/shape concerns and food preoccupation; however, the sample was limited to adolescent participants and outpatient treatment. The current study builds on existing literature by investigating adult ED patients currently in an intensive treatment setting. Participants were randomized to one of two conditions: yoga (n=20) or a wait-list control (n=21). The yoga group completed five weekly sessions of beginner-level Hatha yoga with a focus on breathing and movement, and exploration of body awareness and acceptance through gentle movement and stretching. A series of 2 (condition: yoga, control) by 2 (time: pre and post) repeated measures ANOVAs/MANOVAs were conducted on the self-report measures that were administered. Intention to treat analyses were used. The last observation was carried forward for the 7 people who either dropped out of yoga because of the early time slot (n=3) or who were discharged prematurely from intensive treatment (n=4). As expected results showed a significant main effect for time for most variables measured; all participants improved in weight and shape concerns, anxiety, and depression over time throughout their ED treatment. Additionally, there was a significant time by condition interaction for the Self-Compassion Scale (p=.01). Those in the yoga condition reported a significant increase in self-compassion (pre: M=21.95, SD=6.90; post: M=26.95, SD=7.68), while those in the control condition had a slight drop in self-compassion over the study period. Individuals with ED generally exhibit low levels of self-compassion, which has also been associated with poorer treatment outcome. This is the first study to show that yoga may increase self-compassion in individuals with ED, indicating that yoga can be a valuable and positive adjunct to intensive treatment.

F014: Meta-Analysis of the Effectiveness of Psychological Treatments for Binge Eating Disorder

Marilou Ouellet, BSc; PhD; Student, student in psychology, University of Quebec, Trois-Rivières, Trois-Rivières, Québec, Ève-Line Bussières, PhD, University of Quebec at Trois-Rivières, Trois-Rivières, Quebec, Johana Monthuy-Blanc, PhD, University of Quebec at Trois-Rivières, Trois-Rivières, Quebec, Marie-Pierre Gagnon-Girouard, PhD, University of Quebec at Trois-Rivières, Trois-Rivières, Quebec

The cognitive-behavioral treatment described by Fairburn (2013) is one of the most used treatments for binge-eating disorder in adults. However, there are not enough evidences in the current literature to identify for what symptoms this treatment and its derivatives are the most effective. The aim of this meta-analysis was to compare mean effects of studies that used Fairburn’s treatment and his derivatives with other types of treatments (Mindfulness based therapy, dialectic therapy, behavioural therapy, etc.). A total of 29 independent samples (24 randomized controlled trials) were included (N=1878 adult participants with or without obesity). Treatments based on Fairburn (2013) show large to very large significant effects on frequency of binge eating (d=0.92 [95% CI 0.43 to 1.40]; k=12) and concerns about shape, weight and eating (d=1.06 [95% CI 0.59 to 1.52]; k=15) as well as medium significant effects on dietary restraint (d=0.62 [95% CI 0.19 to 1.05]; k=9) and psychological indicators of well-being (d=0.46 [95% CI 0.17 to 0.75]; k= 17). There was no significant effect on weight reduction. Other treatments show a very large effect on frequency of binge eating (d=1.65 [95% CI 0.11 to 3.19]; k= 3), a large effect on psychological indicators (d=0.69 [95% CI 0.37 to 1.02]; k= 10) and a small effect on concerns about shape, weight and eating (d=0.31 [95% CI 0.14 to 0.49]; k=6), but no significant effect on dietary restraint and weight reduction. These results suggest that different treatments significantly reduce frequency of BE, concerns and psychological indicators, but no treatment addressed all problematic dimensions of BED.

F015: Identifying Fundamental Criteria for Eating Disorder Recovery: A Systematic Review and Qualitative Meta-Analysis

Jan Alexander de Vos, MSc, Human Concern foundation, center for eating disorders, Amsterdam, Noord Holland, Andrea LaMarre, MSc, Guelph University, Guelph

Outcome studies for eating disorder recovery regularly measure only pathology change as an outcome. Researchers, patients and recovered individuals highlight the importance of using additional criteria for measuring eating disorder recovery. There is, however, no clear consensus on which criteria to use. The aim of this study was to find fundamental criteria for eating disorder recovery according to individuals who were considered recovered. A systematic review and a qualitative meta-analytic approach were used. Eighteen studies with recovered patients and meeting various quality criteria were included. Results of the included studies were analyzed using a meta-summery technique where the frequency of the found criteria was examined. Several dimensions of psychological well-being and self-adaptability were found to be fundamental criteria for eating disorder recovery, besides the absence of pathology. The most frequently mentioned criteria were: self-acceptance, positive relationships, personal growth, decrease in eating disorder behavior/cognitions, self-adaptability/resilience and autonomy. Recovered patients rate the presence of aspects of psychological of psychological well-being as important aspects of recovery in addition to the absence of pathology. Supplementary criteria are needed to understand and measure recovery. We recommend to include instruments measuring psychological well-being and self-adaptability in monitors and guidelines for the measurement of eating disorder recovery.

F016: Autistic Trait and Functional Connectivity in Patients with Anorexia Nervosa

Michiko Kawabata-Nishida, MS, Kyoto University, Kyoto, Kyoto, Masanori Isobe, MD; PhD, Kyoto University, Kyoto, Kyoto, Ema Murao, MD, Kyoto University, Kyoto, Kyoto, Tomomi Noda, MA, Kyoto University, Kyoto, Kyoto, Hidehiko Takahashi, MD; PhD, Kyoto University, Kyoto, Kyoto, Toshiya Murai, MD; PhD, Kyoto University, Kyoto, Kyoto, Shun'ichi Noma, MD; PhD, Kyoto University, Kyoto, Kyoto

Autistic trait is reported to be present in patients with eating disorders, and this trait might be related to their difficulties in social situations. However, it is still under debate whether concurrent psychopathology as well as underlying mechanism are in common with the autistic trait seen in general populations, or specific to eating disorders. To elucidate this issue, we investigated brain functional connectivities and their associations of the autistic trait in patients with eating disorders, and compared them with healthy individuals. Specifically, we focused on two networks. The first is the central executive network (CEN) known as a task positive network, which is required for appropriate task performance. The second is the default mode network (DMN), which is deactivated during performance of tasks. MRI data, including rsfMRI data, were acquired for 21 anorexia nervosa (AN group) and 25 age and gender matched healthy controls (Hc group), using T2*-weighted echo-planar sequences (TR=2000ms, TE=30ms), on a 3T scanner. The resting state functional MRI (rsfMRI) data were analyzed by independent component analysis (ICA) using MELODIC, which is provided as a program of FMRIB Software Library (FSL). We analyzed the differences of intra-network connectivity of CEN as well as DMN between AN and Hc. Autistic trait was assessed using a self-reported questionnaire Autism-Spectrum Quotient (AQ). We analyzed the correlations between MRI parameters and the AQ score. AQ total score was significantly higher in AN group compared with Hc group (p<0.05). AN group showed significantly increased CEN compared with Hc group (p<0.05, FWE corrected). We did not observe the group differences in DMN. Functional connectivity in CEN was positively correlated with AQ total score in Hc group, and on the other hand, was negatively correlated with AQ total score in AN group (p<0.05, FWE corrected). Our findings suggest that underlying brain mechanism of autistic trait is different between eating disorder and general populations

F017: Epigenetic Modulation of the Ghrelin System in Acutely Underweight and Recovered Patients with Anorexia Nervosa

Victoria-Luise Zorn, BSc; MSc, Technische Universität Dresden, Dresden, Saxony, Franziska Ritschel, DiplPsych, Technische Universität Dresden, Dresden, Saxony, Lucia Haemmerl, Student, Technische Universität Dresden, Dresden, Saxony, Esther Walton, PhD, Technische Universität Dresden, Dresden, Saxony, Helge Frieling, MD, Medical School Hanover, Hanover, Niedersachsen, Stefan Ehrlich, MD, Technische Universität Dresden, Dresden, Saxony

Ghrelin plays a crucial role in the regulation of hunger and meal initiation. In patients with anorexia nervosa (AN) several studies indicate higher ghrelin levels than in normal weight healthy controls. Recent studies suggest that hormone expression levels may also be modulated by epigenetic mechanism and that AN is characterized by DNA hypermethylation in hormone-related genes. Considering that ghrelin acts on the growth hormone secretagogue receptor (GHSR), the aim of the present study was to examine whether there was evidence of alterations in methylation status of the GHSR gene promoter. We hypothesized that the overall methylation of the GHSR gene promoter and methylation at specific CpG islands will be affected by malnutrition and differ between acutely underweight (acAN) and recovered patients (recAN) compared to healthy controls (HC). DNA methylation of the GHSR gene promoter was determined in peripheral blood mononuclear cells by means of bisulfite conversion and sanger sequencing. We matched groups for age using an automated pairwise matching algorithm (Fuzzy), deriving two matched subsamples with sample sizes of n(acAN) = 42 vs n(HC) = 42 and n(recAN) = 23 vs n(HC)= 23. We used t-tests to compare overall mean promoter methylation and methylation at single CpG in the different groups. Results showed that overall promoter methylation was not statistically different between acAN and HC, or between recAN compared to HC. There was a nominal differences in DNA methylation at CpG 1430 (1430 base pairs upstream of Exon 1) – but this difference was not significant after bonferroni correction. These findings do not lend support to the hypothesis of general DNA hypermethylation in hormone-related genes in AN. Further investigations are required to determine whether epigenetic changes at specific CpG islands in the GHSR gene can predispose individuals to anorexia nervosa.

F018: A School-Based Eating Disorders Prevention Program in Adolescent Girls from Buenos Aires, Argentina

Guillermina Rutsztein, CPsychol; PhD, Facultad de Psicología, Universidad de Buenos Aires., Buenos Aires, Argentina, Brenda Murawski, CPsychol; PhD, Facultad de Psicología, Universidad de Buenos Aires., Buenos Aires, Argentina Leonora Lievendag, CPsychol, Facultad de Psicología, Universidad de Buenos Aires Buenos Aires, Argentina, Jesica Custodio, CPsychol, Facultad de Psicología, Universidad de Buenos Aires., Buenos Aires, Argentina, Luciana Elizathe, CPsychol; PhD, Facultad de Psicología, Universidad de Buenos Aires., Buenos Aires, Argentina, María Luz Scappatura, CPsychol; PhD, Facultad de Psicología. Universidad de Buenos Aires, Buenos Aires, Argentina, Paula Salaberry, BSc, Facultad de Psicología, Universidad de Buenos Aires, Buenos Aires, Argentina, Universidad de Buenos Aires., Julieta Lopez, CPsychol, Facultad de Psicología, Universidad de Buenos Aires, Buenos Aires, Argentina, Eduardo Leonardelli, CPsychol, Facultad de Psicología, Universidad de Buenos Aires, Buenos Aires, Argentina , María Belén Banasco Falivelli, CPsychol, Facultad de Psicología, Universidad de Buenos Aires Buenos Aires, Argentina, Eugenia Domínguez Copello, CPsychol, Facultad de Psicología. Universidad de Buenos Aires, Buenos Aires, Argentina, Germán Bidacovich, CPsychol, Facultad de Psicología, Universidad de Buenos Aires, Buenos Aires, Argentina

The purpose of this study was to evaluate the impact of an intervention aimed at preventing eating disorders (ED) in female adolescents. An intervention based on the principles of the cognitive dissonance theory and on the media literacy approach to education, has been designed. The intervention has been implemented in the course of three sessions in a group format. The sample included 88 female students aged between 12 and 17 (M = 14.49, SD = 1.25) from Buenos Aires, Argentina. Participants completed the following self-administered instruments: Sociodemographic Questionnaire, Cuestionario de Influencia del Modelo Estético Corporal-26 (Questionnaire of influence of the Aesthetic Corporal Model-26, CIMEC-26) and risk subscales of the Eating Disorder Inventory-3 (EDI-3). They were interviewed by the Eating Disorder Examination (EDE). Assessment took place before the intervention, immediately after it and at six months follow-up. After the intervention, scores on two of the subscales of the CIMEC-26 decreased significantly: Body image distress (M = 7.45 for pre vs. M = 6.24 for post, t = 4.34, p < .001) and Mass media influence (M = 2.75 for pre vs. M = 1.94 for post, t = 3.36, p = .001). A similar trend was observed on two of the EDI-3’s risk subscales: Bulimia (M = 6.45 for pre vs. M = 2.45 for post, t = 7.98, p < .001) and Body Dissatisfaction (M = 16.45 for pre vs. M = 14.38 for post, t = 2.45, p = .016). At six months follow-up, this decrease in scores was held in Body image distress (M = 7.45 for pre vs. M = 6.31 for follow-up, t = 3.36, p = .001) and Bulimia (M = 6.45 for pre vs. M = 3.22 for follow-up, t = 4.89, p < .001). The findings are promising and suggest that preventive intervention based on cognitive dissonance and media literacy is effective and feasible and that such programs may be utilized in high schools as natural universal-selective interventions to prevent eating disorders.

F019: Compulsive Treatment of Anorexia Nervosa. Course of Recovery and Patient Experiences

Sigrid Bjørnelv, MD; PhD, Eating Disorder Unit, Department of Psychiatry, Levanger Hospital, Levanger, Nord Trøndelag

Compulsive treatment and forced feeding in anorexia nervosa (AN) has been controversial, the national laws differs, and the scientific literature in unclear. Forced feeding has been particularly debated, and there is a lack of European qualitative studies investigating patient experiences of involuntary treatment and forced feeding in treatment of AN. The aim of this study was twofold: 1) to examine the course of recovery of patients who have been admitted to compulsive treatment in a Norwegian psychiatric hospital in the period 2003 – 2012. 2) to assess the patient's perception and experiences of involuntary hospital admissions and the use of forced feeding. In total, eleven women with AN were admitted for compulsory treatment with forced feeding. One of the patients had died, the remaining ten were invited to participate in the study, and eight gave their consent to participate. All participants were assessed using self-report questionnaires measuring eating disorder symptoms and general psychiatric symptomatology at admission, discharge and follow up. Medical history was collected and we conducted a semi-structured interview about their experiences on involuntary treatment and coerced feeding. At follow-up, 60 % (N:6) reported that they no longer had an eating disorder, one presented with severe AN, and 1 patient had relapsed. Two patients had a BMI below 17.5, while the others (N:6) had a normal weight. There was a clear reduction of symptoms of eating disorders and psychiatric symptoms in all assessments during follow up, and an improvement in global function. The participants' experiences of compulsory treatment and forced feeding varied widely from undoubtedly negative to positive experiences. Coercion is an infringement on an individual’s liberty, but may save lives of young patients and also gives a better prognosis. Clinicians should decide when involuntary treatment should be implemented with respect for the patient’s autonomy.

F020: Moderating Thin Ideal Internalization: The Indirect Impacts of Personality on Body Satisfaction

Alena Borgatti, BA, Lewis & Clark College, Portland, Oregon, Janet Davidson, PhD, Lewis & Clark College, Portland, Oregon

According to the sociocultural model of eating disorders, media internalization acts as a catalyst for eating disorder pathology and development. However, the effects of the thin ideal on disordered eating varies throughout the literature, suggesting that additional factors and individual predispositions may moderate this relationship. The current study assessed the influence of personality indices on physiological, psychological, and behavioral responses linked with disordered eating following an experimental induction of the thin ideal. 52 healthy undergraduate females completed personality measures of self-discrepancy and self-consciousness, and were randomly assigned to read thin ideal (TI) or neutral (N) magazine articles. After reading, participant’s Galvanic Skin Responses (GSR) to presentation of a doughnut were measured. Participants then ate their doughnut and completed the Body Satisfaction Scale (BSS). No correlations existed between TI versus N conditions on any pre-manipulation measures, suggesting participants did not differ significantly prior to assignment. The study found several significant correlations between BSS scores and self-discrepancies (r (50)= -.285, p=.041, and r(50)=-.334, p=.016) as well as public self-consciousness (r(50)=-.292, p=.036). Univariate ANOVAs assessed the interactions between condition and personality traits in relation to body satisfaction, doughnut consumption, and GSR amplitude change. Higher Public Self-Consciousness significantly interacted with TI condition to decrease body satisfaction (F(1, 47)=4.741, p=.035) and doughnut consumption(F(1, 48)=4.061, p=.050). Additionally, results showed an interaction between TI condition and food intake on GSR (F(1,42)=7.672, p=.008). Together, these findings support a psychosociocultural model of eating pathology development through thin ideal media exposure moderated by self-discrepancy and self-consciousness.

F021: The Use and Value of the 7-Item Binge Eating Disorder Screener in Clinical Practice

Barry Herman, MD, Shire Pharmaceuticals, Lexington, Massachusetts, Linda Deal, MSc, Pfizer, Collegeville, Pennsylvania, Dana DiBenedetti, PhD, RTI Health Solutions, Research Triangle Park, North Carolina, Lauren Nelson, PhD, RTI Health Solutions, Research Triangle Park, North Carolina, Sheri Fehnel, PhD, RTI Health Solutions, Research Triangle Park, North Carolina, T. Michelle Brown, PhD, RTI Health Solutions, Research Triangle Park, Mississippi

This study evaluated physician knowledge of and attitudes about binge eating disorder (BED) and the value and ease of use of the 7-Item Binge Eating Disorder Screener (BEDS-7) in clinical practice. Two internet surveys (wave 1 [April 15–May 6, 2015]; wave 2 [August 19–25, 2015]) were administered to general practitioners (GPs) and psychiatrists. Wave 1 invitees were from a panel of US-based physicians spending ≥50% of their time in direct patient care and reporting “no” to “some to average” experience with eating disorder patients; respondents completing wave 1 qualified for wave 2. A total of 122 GPs and 123 psychiatrists completed both waves. Composite BED knowledge (percent correct) increased from wave 1 to wave 2 in GPs (55.2% to 60.0%, P<0.001) and psychiatrists (73.0% to 76.4%, P<0.05); GP knowledge was lower in both waves (both P<0.001). Composite belief scores about the importance of being knowledgeable about BED were high in both groups in both waves. Composite comfort scores for diagnosing and treating BED were significantly lower in GPs than psychiatrists in both waves (both P<0.001). The BEDS-7 was used in clinical practice by 32.0% of GPs and 26.8% of psychiatrists. During wave 2, all BEDS-7 users reported the BEDS-7 to be “very” or “somewhat” valuable and nearly all BEDS-7 users (GPs: 97.4%; psychiatrists, 100%) reported the BEDS-7 to be “very” or “reasonably” easy to use. A majority of BEDS-7 users (GPs and psychiatrists) reported that important uses of the BEDS-7 included assisting clinicians in identifying BED patients (71.8% and 87.9%) and encouraging/initiating doctor-patient discussions about BED (71.8% and 66.7%). These data indicate that knowledge of and comfort with diagnosing and treating BED was higher in psychiatrists than GPs, but both groups acknowledged the importance of being knowledgeable about BED. In addition, respondents who used the BEDS-7 in clinical practice reported that it was a highly valued, easy-to-use screener for BED.

F022: The Changing Profile of Feeding and Eating Disorders in a Japanese Clinical Sample

Yoshikatsu Nakai, MD, Kyoto Institute of Health Sciences, Kyoto, Kyoto, Kazuko Nin, PhD, School of Health Sciences, Faculty of Medicine, Kyoto University, Kyoto, Kyoto, Shun'ichi Noma, MD, Department of Psychiatry, School of Medicine, Kyoto University, Kyoto, Kyoto, Kimihiro Suzuki, PhD, Tokyo Future University, Tokyo, Tokyo, Stephen A. Wonderlich, PhD, Department of Clinical Neuroscience, University of North Dakota, Fargo, North Dakota

The purpose of this study is to examine the changing profile of feeding and eating disorders in a Japanese clinical sample between 1965 and 2015. We completed a retrospective review of 1349 patients (432 adolescents and 917 adults) with a feeding and eating disorder (FED) assessed with a standard clinical interview by eating disorder specialists between 1965 and 2015. The patients seen among 1965-1977 (period I, n=34), 1978-1990 (period II, n=395), 1991-2003 (period III, n=469) and 2004-2015 (period IV, n=451) were compared. In period I, 10 (29%) patients were categorized as having anorexia nervosa (AN), 7 (21%) as having avoidant/restrictive food intake disorder (ARFID) and 17 (50%) as other specified FED (OSFED). There was no participant with bulimia nervosa (BN) or binge-eating disorder (BED) in period I. In period II, 139 (34%) patients were categorized as having AN, 119 (30%) with BN, 12 (3%) with BED, 45 (11%) with ARFID and 89 (22%) with OSFED. In period III, 151 (32%) were categorized as having AN, 173 (37%) with BN, 20 (4%) with BED, 35 (8%) with ARFID and 90 (19%) with OSFED. In period II-III, there was a general increase in the proportion of patients with binge eating/purging and/or over-concern with body weight/shape. In period IV, 294 (34%) were categorized as having AN, 392 (45%) with BN, 109 (11%) with BED, 26 (3%) with ARFID and 56 (6%) with OSFED. In period IV, the proportion of ARFID patients decreased and the proportion of BED patients increased. The overview of the risk factors of FEDs in each period revealed the increasing role of sociocultural background on FEDs in Japan. There were some differences and similarities in the risk factors of FEDs between Japan and Western countries.

F023: Disordered Eating and Body Image Pathology Among Women on Gluten-Free Diets

Leah Boepple, MA, University of South Florida, Tampa, Florida, Joel (Kevin) Thompson, PhD, University of South Florida, Tampa, Florida

Limited research has investigated the relationships between specific dietary lifestyles (i.e., vegetarianism, veganism, gluten free) and disordered eating and body image pathology. Findings of a 2012 study suggest that individuals with a previous eating disorder diagnosis report higher rates of current and past vegetarian diets (Bardone-Cone et al.). Dietary restraint is both associated with and predicts disordered eating and body image pathology (Delinsky & Wilson, 2008; Stice, 2002), suggesting that individuals who restrict their diets are at increased risk of disordered eating and body image pathology. Recent polls suggest that 1 in 6 Americans endorse a gluten free diet (Gallup, 2015); however, no research to date has investigated the relationships between gluten free diets and disordered eating and body image pathology. The current study was an investigation of these relationships. Participants were 156 (78 Gluten Free; 78 non Gluten Free) undergraduate females at a university in the southeastern united states. Body image and eating pathology constructs were measured (i.e., Eating Disorder Examination-Questionnaire: restraint & shape/weight/eating concern; Physical Appearance Comparison Scale-R: Appearance comparison; Objectified Body Consciousness Scale: body image). T-test analyses revealed that individuals on gluten free diets reported significantly higher body image and disordered eating pathology than individuals not on gluten free diets. These results suggest that individuals on gluten free diets may report higher levels of disordered eating and body image pathology than individuals not on gluten free diets. Results will be further explored and implications will be discussed.

F024: Neural Correlates of Cognitive Control in Patients Recovered from Anorexia Nervos 

Franziska Ritschel, DiplPsych, TU Dresden, Dresden, Saxonia, Daniel Geisler, MSc, TU Dresden, Dresden, Saxonia, Joseph A. King, MSc; PhD, TU Dresden, Dresden, Saxonia, Richard Vettermann, Student, TU Dresden, Dresden, Saxonia, Veit Roessner, MD, University Clinic Dresden, Dresden, Saxonia, Michael N. Smolka, MD, TU Dresden, Dresden, Saxonia, Stefan Ehrlich, MD, University Clinic Dresden, Dresden, Saxonia

Recently, we found increased neural response in dorsal anterior cingulate cortex (dACC) in acutely ill anorexia nervosa patients (acAN) during lose-shift trials in a probabilistic reversal learning (PRL) task. Given the generally preserved task performance we interpreted the findings as suggestive of increased cognitive control. However, severe undernutrition in acAN may also affect brain function. Therefore, the aim of the current study is to investigate neural correlates of cognitive control/performance monitoring in patients recovered from AN (recAN) to detect possible persisting neural changes after recovery. Thirty-one recAN and 31 healthy participants completed a PRL task during fMRI. We analyzed task performance and hemodynamic response during trials with negative feedback that incurred a change in behavior (lose-shift) and conducted functional connectivity analysis. RecAN showed impaired task performance and an elevated number of behavioral switches compared to healthy controls. On the neural level, recAN showed normal responses in dACC, but increased activation in the left inferior frontal junction (IFJ) and bilateral angular gyrus (AG) during lose-shift. Functional connectivity analysis revealed a trend for increase in coupling between IFJ and left AG during lose-shift in recAN. Our results in recAN differ from that of our previous study in acAN. Current findings of reduced task performance, but increased neural responses in cognitive control regions (IFJ, AG, but not the dACC) during a PRL task may indicate neural inefficiency of these brain regions in recAN.

F025: Neural Mechanisms Underlying Guided Exposure Therapy in Patients with Anorexia Nervosa

Samantha Rennalls, BSc; MSc Student, King's College London, London, UK, Valentina Cardi, BSc; MSc; DClinPsy; PhD; King's College London, London, UK, Iain Campbell, BSc; DSc; PhD, King's College London, London, UK, Janet Treasure, MD; PhD; FAED, King's College London, London, UK, Owen O'Daly, BSc; MSc; PhD, King's College London, London, UK

Anorexia nervosa (AN) is characterised by a persistent desire to be thin, severe restriction of food intake and an intense fear of gaining weight. The food-related anxiety experienced by individuals with AN can be a key barrier to successful treatment. Guided exposure therapy is an established intervention for anxiety disorders, and is developed based on fear extinction principles. This study investigates the neural underpinnings of exposure therapy to yield potential mechanistic insight. A particular focus was placed on how motivational systems and sensory input pathways are influenced by exposure therapy. Sixteen patients with AN completed a range of self-report measures and underwent a functional magnetic resonance imaging (fMRI) scan before and after receiving 10 sessions of exposure therapy sessions over 3 months. A matched healthy control group (n=20) also had two brain scans 3 months apart. During the scans, participants completed a food image paradigm, comprised of blocks of food and non-food images. Patients reported a decrease in food-related anxiety, eating-related concern and preoccupations, and an increase in confidence to change. While context-dependent (i.e. food vs non-food) modulation of functional connectivity (CDMFC) of the occipital lobe with the amygdala and insula was not altered, a significant group (healthy controls vs patients) x time point (before vs. after exposure therapy) interaction in CDMFC between the visual cortex and striatum was observed. Whilst top-down processing may be influenced by the exposure therapy, changes in bottom-up sensory processing may also play a key role in altering patients experiences of food, due to the altering of the routing of sensory information to motivational circuits in AN following exposure therapy.

F026: Thin Ideal Internalization: How Much Is Too Much?

Lauren Schaefer, MA, University of South Florida, Tampa, Florida, Natasha Burke, PhD, Uniformed Services University of the Health Sciences, Bethesda, Maryland, J. Kevin Thompson, PhD, University of South Florida, Tampa, Florida

Internalization of the thin ideal is a risk factor for eating disorders that frequently persists into recovery and increases patient risk for relapse. Addressing thin ideal internalization (TII) as a core element of eating disorder prevention and treatment produces significant reductions in eating pathology. However, research has not yet quantified levels of TII that may signal increased versus decreased risk for disordered eating. To address this gap in the literature, receiver operating characteristic (ROC) curve analysis was used to identify a TII cutoff score that signified clinically-meaningful eating disorder pathology. 787 college women (age M=20.17, SD =2.41; BMI M=23.58, SD=5.29) were classified as “healthy” (N=717) or “eating disordered” (N=70) using established clinical cutoffs for the Eating Disorder Examination-Questionnaire (EDEQ). ROC curve analysis was used to test the performance of the Sociocultural Attitudes Towards Appearance Questionnaire-4 (SATAQ-4) Internalization: Thin/Low Body Fat subscale in predicting disordered eating status, and identify a cutoff score that maximized sensitivity and specificity to discriminate between healthy and eating disordered samples. Mean SATAQ-4 internalization scores were 3.27 (SD=0.92) and 4.27 (SD=0.62) for healthy and eating disordered participants, respectively. The SATAQ-4 internalization scores were good predictors of disordered eating status (area under the curve=.81, 95% CI: .76-.86). The optimal cutoff of 3.78 (measured on a 1-5 Likert scale) yielded a sensitivity of .81 and specificity of .64. Overall, results provide preliminary support for the discriminant validity of SATAQ-4 thin internalization scores and suggest that even moderate levels of TII may be predictive of clinically-significant eating pathology. It may be important for prevention and intervention work to actively seek to reduce internalization levels below this clinical cutoff, though future work is needed to bear this out.

F027: Therapist Drift in Cognitive Behavioural Therapy for Eating Disorders: Differences between the UK and Latin America

Maria Elena Hernandez Hernandez, BA; MSc, University of Sheffield, Sheffield, Yorkshire, Glenn Waller, BA; MPhil; DPhil; FAED; University of Sheffield, Sheffield, Yorkshire, Eva Trujillo, MD; FAED, Comenzar de Nuevo Eating Disorders Center, Mexico, Mexico

This study aimed to determine how widely core CBT techniques for eating disorders are used by clinicians of different cultural backgrounds - specifically, Latin America and the United Kingdom. Specific a priori predictions were made, based on Hofstede’s model of personal and social characteristics of individuals in different cultures. The sample consisted of 30 UK and 45 Latin American therapists who delivered CBT for eating disorders (mean age = 38.3 years; 82.5% females). Participants were approached via e-mail and completed an online survey about the frequency of use of individual CBT techniques, along with tests of anxiety, personality and social desirability. Entirely in line with theoretical predictions, UK clinicians were more likely to use specific CBT techniques (introduction of regular meals; behavioural experiments; exposure work; monitoring physical risk; weighing the patient), while Latin American therapists were more likely to use pre-therapy motivation work. UK therapists were also more likely to use a range of general CBT techniques (thought records; homework; monitor progress; agenda-setting). In contrast, Latin American clinicians were more likely to use methods that are unsupported in CBT (e.g., relaxation; encourage the patient to talk about whatever was on their mind). As predicted, differences in clinician personality (particularly extraversion) explained some of these differences in therapy implementation. There are cultural differences in the delivery of CBT for eating disorders, with greater evidence of therapist drift in Latin American countries. Those differences are as predicted from cultural theories, and seem to centre on personality differences across the cultures. Supervision and training in manualized protocols is recommended for clinicians from both cultural backgrounds, but this is especially important for Latin American clinicians, since most of the protocols are in English and this creates a language barrier.

F028: The Efficacy Of Psychological Therapies in Reducing Weight And Binge Eating In People With Bulimia Nervosa And Binge Eating Disorder Who Are Overweight Or Obese - A Critical Synthesis And Meta-analysis

Marly Palavras, MSc; Student, Federal University of São Paulo and CAPES Foundation, Ministry of Education, São Paulo, São Paulo, Phillipa Hay, DPhil; FAED Western Sydney University and CAPES Foundation, Ministry of Education, Brazil, Sydney, South Wales, Celso Alves dos Santos Filho, MSc, Federal University of São Paulo, São Paulo, São Paulo, Angélica Claudino, PhD, Federal University of São Paulo, São Paulo, São Paulo

Recurrent binge eating episodes, the core feature of Bulimia Nervosa (BN) and Binge Eating Disorder (BED), are frequently comorbid with obesity. Psychological interventions, notably Cognitive Behavioural Therapy (CBT), are effective for binge eating reduction in BED or BN but not for weight loss. Behavioural weight loss treatment (BWLT) shows effectiveness for binge eating reduction and weight loss but this appears poorly sustained over time. Our aim was to review evidence for efficacy of psychological therapies for the BN/BED associated with overweight or obesity. A systematic search for randomized controlled trials with adult samples who had BN or BED was conducted considering articles in English, French, Spanish and Portuguese with no restrictions for the timeline publication ending in March, 2016. A quality appraisal of the trials and a meta-analysis comparing BWLT to CBT was done. 1830 articles were screened and 19 published articles were selected. Insufficient evidence was found for superiority for BWLT efficacy considering binge eating remission, reduction of binge eating frequency and weight loss. More research is needed to test the efficacy of psychological treatments for BED or BN with co-morbid overweight or obesity, including trials evaluating binge eating remission and weight loss in the long-term.

F029: Maladaptive Eating Behaviors and Metabolic Profile in Patients Submitted to Bariatric Surgery: A Longitudinal Study

Eva Conceição, PhD, School of Psychology, University of Minho, Braga, Braga, Mara Pinho, MD; MSc, Faculty of Medicine, University of Porto, Hospital de São João, Porto, Porto, Isabel Brandão, MD; PhD, Faculty of Medicine, University of Porto, Hospital de São João, Porto, Porto, Diogo Pestana, MD; PhD, Cintesis-Center for Research in Health Technologies and Information Systems, Porto, Porto, Li Cao, MSc, Neuropsychiatic Research Institute, Fargo, North Dakota, Filipa Arrojado, MSc, School of Psychology, University of Minho, Braga, Braga, Ana R. Vaz, PhD, Schooil of Psychology, University of minho, Braga, Braga, Ana Pinto-Bastos, MSc, School of Psychology, University of Minho, Braga, Braga, Ana Pinto-Bastos, MSc, School of Psychology, University of Minho, Braga, Braga

To investigate relations between maladaptive eating behaviors (MEB) and metabolic profile in patients submitted to bariatric surgery. Longitudinal study including 70 patients before (T0), in the first year after surgery assessment (T1) and the second year after surgery assessment (T2). A face-to-face clinical interview assessed MEB at T0 and T2. Blood samples were collected at T0, T1 and T2 to assess fasting plasma glucose (FPG); glycated haemoglobin (HbA1c); insulin; insulin resistance (IR); triglycerides (TG). Mixed model analyses with growth curves tested the differences between patients with MEB (M-group) and non-MEB patients (NM-group) on the course of metabolic parameters, while controlling for total weight loss and type of surgery. No differences between both groups was reached for levels of FPG (F(1,140)=2.936, p=0.089), HbA1c(F(1,96)=0.099, p=0.754), insulin (F(1,121)=0.146, p=0.703), IR (F(1,60)=0.976, p=0.327) and TG (F(1,128)=0.725, p=0.396). All parameters improved from T0 to T1 for both groups. A distinct trend on the course of metabolic markers in M-group, but not NM-group is observed, presenting an increase in HbA1c levels, insulin and TG levels. Both groups progressed favorably in the first 12 months of surgery. MEB may be associated with a trend for deterioration of metabolic profile after 12 months of surgery. The study should be replicated with longer term assessments and a larger sample size.

F030: Psychometric Properties of the Contextual Body Image Questionnaire for Female Athletes

Carolyn Becker, PhD, Trinity University, San Antonio, Texas, Nicole Wesley, BA, Pennington Biomedical Research Center, Baton Rouge, Louisiana, Robbie Beyl, PhD, Pennington Biomedical Research Center, Baton Rouge, Louisiana, Lisa Kilpela, PhD, University of Texas Health Science Center San Antonio, San Antonio, Texas, Ron Thompson, PhD, Retired, Bloomington, Indiana, Roberta Sherman, PhD, Retired, Bloomington, Indiana, Tiffany Stewart, PhD, Pennington Biomedical Research Center, Baton Rouge, Louisiana

First identified by de Bruin (2010), contextual body image (CBI) refers to the dual nature of female athlete body image, which consists of body image in sport and in everyday life. Body dissatisfaction has been identified as a significant risk factor for numerous negative outcomes (e.g., depression, eating disorders (ED), unhealthy weight control behaviors) in non-athletic populations; yet the association of CBI with negative outcomes has received less attention. One challenge in studying CBI has been the lack of a well-established measure. This poster presents data pertaining to the psychometric properties of the Contextual Body Image Questionnaire for Athletes. In the only validation study to date, de Bruin et al. found that the CBIQ consisted of four factor for each body image dimension (i.e., sport and daily life): Appearance, muscularity, thin-fat self-evaluation, and thin-fat others’ opinions. To replicate results from de Bruin et al., we conducted a confirmatory factor analysis with data from the Female Athlete Body (FAB) Project. The CBIQ was given at 12- and 18-month follow-up and each time point was analyzed separately (12-month n = 386; 18-month n = 352). Results largely confirmed the original factor analysis. A two sample t- test comparing female athletes with high and low ED pathology on the eight main CBIQA factors showed significant differences between the two groups for each factor, with the exception of muscularity. Linear models for each of the four factors tested the differences between body image in sport and daily life. Significant differences were found between the two contextual body images for the factors of muscularity, appearance, and others’ opinions. Finally, this presentation explores the degree to which 12-month sport and daily life thin-ideal internalization predicts 18-month contextual body image and the degree to which 12-month contextual body image predicts 18-month ED pathology and negative affect.

F031: The Relationship between Motor-Related Body Schema and Body Image Impairments in Eating Disorders: A Preliminary Study

Giovanna Cristina Campione, PhD; PsyD, Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, LC, Beatrice Fumagalli, PsyD, Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, LC, Gianluigi Mansi, MD, Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, LC, Alessandra Fumagalli, PsyD, Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, LC, Nadia Micali, FAED; MD; MRCPsych; PhD, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York

Body representation disturbances in body image (i.e. conscious perceptual/affective body representations) and body schema (i.e. unconscious sensorimotor body representations for action) are core symptoms in Eating Disorders (EDs). However, the nature of these disturbances and the relationship between body image and body schema have not been fully elucidated yet. Recently, it has been proposed that body schema directly depends on the motor system, which is strongly implicated in discriminating between one’s own and someone else’s body. The aim of the present study was twofold. First, we investigated whether the ability to implicitly recognize one’s own body was impaired in EDs as part of body schema disturbance. Secondly, we studied whether this impairment was associated with body image distortion. Female outpatients diagnosed with EDs (N=15), and healthy controls (N=18) matched for age, handedness, BMI, and education underwent a task involving a laterality judgment and implicit self-recognition (i.e. motor mental rotation of their own and someone else’s hands). Group differences in the temporal advantage when processing self vs. non-self stimuli (i.e. self-advantage effect, SAE) were evaluated by means of a mixed ANOVA. Correlation analyses were carried out between SAE size and perceptual and affective body image-related scores. Statistical analyses confirmed that controls showed a SAE, whereas EDs did not (p=0.02). SAE negatively correlated with affective body image (r=-0.34, p=0.04). This study provides initial indication that motor function might be compromised as part of body schema disturbances in EDs, and this impairment correlates with body image disturbance.

F032: Understanding Treatment Moderation in Adolescent Anorexia Nervosa: What is The Clinical Meaning of Elevated Yale-Brown-Cornell Eating Disorder Scale Scores?

Molly Vierhile, BA, Stanford University, Stanford, California, Shiri Sadeh-Sharvit, PhD, Stanford University, Stanford, California, Linsey Utzinger, PsyD, Stanford University, Stanford, California, James Lock, MD; PhD; FAED, Stanford University, Stanford, California

Moderators are clinical characteristics that help clinicians match patients to treatment most likely to be effective for them. Elevated scores on the Yale-Brown-Cornell Eating Disorder Scale (YBC-ED) are the only replicated moderator for adolescents with anorexia nervosa (AN), and suggest that patients respond better to FBT than other approaches but will likely need longer treatment. However, YBC-ED scores are not typically available in clinical settings, so the practical clinical relevance of this moderator is limited. The current study examines the relationship of clinical characteristics of adolescents with AN and the YBC-ED to improve the clinical relevance of this moderator. To conduct this study we utilized stepwise regression of clinical variables (e.g., Global Score on the Eating Disorder Examination (EDE-G), co-morbid psychiatric diagnosis assessed by the Beck Depression Inventory (BDI), Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS), age adjusted IBW, age, and duration of AN) in two independent samples from two separate treatment studies that employed the same inclusion and exclusion criteria. The results of the first sample tested (N=158) found that elevated YBC-ED scores were significantly associated with elevated eating-related psychopathology and higher levels of co-morbidity of depressive symptoms and obsessionality. We attempted to replicate these findings in a second independent sample (n=45), and found that elevated YBC-ED scores were again significantly associated with elevated EDE-G and CY-BOCS scores. We conclude that YBC-ED likely captures relevant clinical constructs related to severity (e.g., eating related psychopathology) and complexity (co-morbid symptoms of depression and obsessionality). In a clinical setting where YBC-ED scores are not typically available, clinicians should consider matching patients with elevated eating related psychopathology and co-morbid obsessive-compulsive symptoms to FBT and expect treatment to be longer in duration

F033: The Neurobiology of Binge Eating: A Systematic Review

Brooke Donnelly, MPsych, PhD Candidate; BSc, University of Sydney, Sydney, NSW, Phillipa Hay, MBBS; PhD; FAED Western Sydney University, Sydney, NSW, Stephen Touyz, DClinPsy; PhD, University of Sydney, Sydney, NSW

Eating disorders are serious, complex mental illnesses. Binge eating is a debilitating cardinal symptom of eating disorders, seen across the Diagnostic and Statistical Manual (DSM-V) eating disorder diagnostic groups. Recurrent binge eating is a diagnostic criteria for Bulimia Nervosa (BN), Binge Eating Disorder (BED), Anorexia Nervosa-Binge Purge type (AN-BP) and is a common feature of Other Specified Feeding and Eating Disorder (OSFED). With advances in neuroimaging techniques, there is an emerging body of research on the neurobiological processes and potential underpinnings of Anorexia Nervosa. There have been a large number of structural neuroimaging studies completed since the 1980’s, followed by a growing body of research using functional magnetic resonance imaging (fMRI) in more recent years. However the neurobiological research on BN and BED is not as substantial. A systematic review, summarising the current state of the literature regarding the neurobiology of binge eating, was lacking. A systematic literature search was completed across five electronic databases: PubMed, PsycInfo, Medline, Web of Science and Google Scholar. A quality appraisal of papers was undertaken. To be included in the systematic review, papers had to be an original research study, human research, English language, used samples or participants with a diagnosed eating disorder and included a control sample. Overall, 45 studies were included in the review. The findings summarise a number of structural and functional brain differences found in individuals with a diagnosed eating disorder characterised by recurrent binge eating, including: Areas of neural activation in response to images of food; reward-related brain regions; neurotransmitter function; regional cerebral blood flow; and, blood oxygen level dependent response (BOLD). A clear and comprehensive understanding of the neurobiological functioning of people who binge eat is important, as it provides information on the future directions of psychological and pharmacological treatment for this complex clinical group.

F034: Executive Difficulties in Patients with Anorexia Nervosa or Bulimia Nervosa

Siri Weider, PhD, Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Sør-Trøndelag, Marit Sæbø Indredavik, MD; PhD, Regional Centre for Child and Youth Mental Health and Child Welfare, NTNU, Trondheim, Sør-Trøndelag, Knut Hestad, PhD, Department of Research, Innlandet Hospital Trust, Brumunddal, Hedmark

A number of studies have found difficulties in executive functioning in patients with anorexia nervosa (AN) and bulimia nervosa (BN). However, most studies have investigated only a limited number of executive functions. The aim of this study was to assess performance over several executive domains using a number of neuropsychological tests. A total of 40 patients with AN and 39 patients with BN from the Specialised Eating Disorder Unit at Levanger Hospital, Norway, participated in a larger study on neuropsychological functioning, and was compared to a group of 40 healthy controls (HCs). All patients completed a test-battery measuring the following domains with the following neuropsychological tests: set-shifting: (Category Test, Wisconsin Card Sorting Test, Trail Making Test, Part B); planning (Tower Test), inhibition (Color-Word Interference Test), verbal fluency (Verbal Fluency Test) and working memory (Paced Auditory Serial Addition Test [PASAT], Spatial Span from Wechsler Memory Scale-Revised and Letter Number Sequencing and Digit Span from Wechsler Adult Intelligence Scale-III). Significant differences were found between the groups on all measures within the set-shifting, planning and inhibition domains. Within the working memory domain, there were some differences on the PASAT and on measures of spatial span. There were no differences on any measures from the Verbal Fluency Test. Post-hoc tests revealed that the AN group performed below the HCs on all measures within the set-shifting, planning and inhibition domain and also below the BN group on both measures of inhibition. In addition, the AN group performed below the HCs on the PASAT and on a measure of spatial span. The BN group performed significantly below the HCs only on the PASAT. The results reveals that patients with AN show significant difficulties over several domains of executive functioning, while patients with BN show some difficulties related to working memory.

F035: The Role of Neuropsychological Features in Predicting Response to Treatment in Anorexia Nervosa

Elena Tenconi, PhD; PsyD, Department of Neuroscience, University of Padova, Padova, Italy, Elisa Bonello, PsyD, Department of Neuroscience, University of Padova, Padova, Italy, Giovanni Croatto, MD, Department of Neuroscience, University of Padova, Padova, Italy, Daniela Degortes, PhD; PsyD, Department of Neuroscience, University of Padova, Padova, Italy, Tatiana Zanetti, PsyD, Department of Neuroscience, University of Padova, Padova, Italy, Tommaso Catapano, MD, Department of Neuroscience, University of Padova, Padova, Italy, Paolo Santonastaso, MD, Department of Neuroscience, University of Padova, Padova, Italy, Angela Favaro, MD; PhD, Department of Neuroscience, University of Padova, Padova, Italy

Neuropsychological impairments in anorexia nervosa (AN) have been considered both as putative risk factors and as a target for treatment. However, the role of neuropsychological variables as predictors of outcome is not clear. The aim of this study is to investigate the role of neuropsychological variables as predictors of response to treatment in a group of individuals affected by AN. The study sample consisted of 144 patients diagnosed with acute AN, according to the DSM-5 criteria, referred to the Eating Unit of the Hospital of Padova, Italy. All participants were assessed by means of a neuropsychological and clinical test battery at intake and followed during outpatient treatment for an average of 531 days. 83% of the patients underwent cognitive-behavioral therapy, the families of 75% of the patients were included in the treatment and 48% of the patients took antidepressants (SSRI). Both body mass index at assessment and illness duration appeared to be independent factors significantly affecting the outcome. The role of neuropsychological variables was explored including cognitive performance in a multivariate analysis including BMI at intake, duration of illness and diagnostic subtype. The inclusion in the model of the Wisconsin Sorting Card Task performance and the central coherence index (calculated by using the Rey Figure Test) significantly increased the prediction ability of the model for full remission at the end of treatment. This is the first study to show that neuropsychological characteristics may predict treatment response in AN. These data support the implementation of cognitive remediation techniques in the treatment of AN.

F036: Decision-Making and Anorexia Nervosa: Clinical and Neuropsychological Correlates

Elena Tenconi, PhD; PsyD, Department of Neuroscience, University of Padova, Padova, Italy, Valeria Giannunzio, MD, Department of Neuroscience, University of Padova, Padova, Italy, Daniela Degortes, PhD; PsyD, Department of Neuroscience, University of Padova, Padova, Italy, Elisa Bonello, PsyD, Department of Neuroscience, University of Padova, Padova, Italy, Enrico Collantoni, MD, Department of Neuroscience, University of Padova, Padova, Italy, Jessica Lamponi, PsyD, Department of Neuroscience, University of Padova, Padova, Italy, Silvia Michelon, MD, Department of Neuroscience, University of Padova, Padova, Italy, Giovanni Miotto, MD, Department of Neuroscience, University of Padova, Padova, Italy, Angela Favaro, MD; PhD, Department of Neuroscience, University of Padova, Padova, Italy, Paolo Santonastaso, MD, Department of Neuroscience, University of Padova, Padova, Italy

The present study aims at investigating decision making (DM) abilities in patients with anorexia nervosa (AN). In particular, we were interested in exploring the relationship between DM and age (adolescence versus adulthood) and between DM and diagnostic status (acute AN, weight-recovered eating disorder and fully recovered AN). The Expectancy Valence Model (EVM) was applied to explore the psychological processes related to DM. Finally, we considered the relationship between DM and the course of the treatment. The participants were 268 patients with a lifetime diagnosis of AN and 230 healthy women. All subjects underwent clinical and neuropsychological assessment. In order to explore the relationship between the IGT performance and the weight changes during treatment, linear regression analysis was performed with the IGT net score as the independent variable and the BMI at 3 months, at 6 months, at 12 months and final BMI as the dependent variables. An additional variable, called Δ (delta) BMI was used, that is the difference between the final BMI and the BMI at moment of neuropsychological assessment. In adult subjects, a significant difference emerged in the IGT performance in the comparison between patients and healthy women. No difference, on the contrary, emerged in the comparison between adolescent patients and controls. Adolescent patients displayed lower scores in the “updating rate” parameter and the “motivational parameter” of EVM in comparison to healthy adolescents, whereas no differences emerged in adults. Considering the diagnostic status, no significant differences emerged between acute AN, weight recovered eating disorder and fully recovered AN on the IGT performance and EVM parameters. IGT performance did not predict response to treatment at 3, 6 and 12 months of treatment, but was significantly associated with delta BMI. In conclusion, our study revealed a different decision making profile in adolescent and adult patients with AN, as well as a relationship between decision making abilities and the amount of weight gain. A characterisation of the developmental trajectories of decision making abilities may provide a better understanding of AN psychopathology and may yield the development of tailored treatment strategies.

F037: The Role of Craving in Emotional and Uncontrolled Eating: A Test and Extension of Cognitive Processing Model of Alcohol Craving

Christina Verzijl, BA, University of South Florida, Tampa, Florida, Brittany Lang, BS; MA University of South Florida, Tampa, Florida, Erica Ahlich, BA, University of South Florida, Tampa, Florida, Diana Rancourt, BA; MA, PhD University of South Florida, Tampa, Florida, Robert Schlauch, BA; MS; PhD, University of South Florida, Tampa, Florida

Recent applications of addictive models to disordered eating have received preliminary support. One model that may be relevant to overeating is the cognitive processing model of alcohol craving. This model posits that when alcohol is unavailable, an individual’s craving for alcohol increases, leading to increased alcohol consumption. This model may be particularly useful in predicting uncontrolled (UE) and emotional eating (EE) among individuals engaging in restrained eating (RE). Specifically, individuals high in RE may report higher food craving and higher subsequent UE and/or EE. Food craving was examined as an indirect effect of the association between RE and 1) UE and 2) EE. A total of 1069 individuals participated via Amazon’s Mechanical Turk (59.68% female; M age = 37.11, SD = 11.79) and completed the Trait General Food Craving Questionnaire, the Restrained Eating subscale of the Dutch Eating Behavior Questionnaire, and the uncontrolled and emotional eating subscales of the Three Factor Eating Questionnaire. Two models of indirect effects were estimated in SPSS using bootstrapping. Results suggested higher levels of RE were associated with higher levels of food craving (b = 0.47, 95% CI = [.33, .59]), p < .001), which were associated with more frequent uncontrolled (b = 0.21, 95% CI = [.20, .22], p < .001) or emotional eating (b = 0.17, 95% CI = [.15, .18], p < .001). Craving emerged as an indirect effect in both models, accounting for 84% of the total effect in the UE model (b = .01, 95% CI = [.07, .13]) and 79% of the total effect in the EE model (b = .08, 95%CI = [.06, .10]). These findings broaden our understanding of the negative effects of RE on eating patterns. In particular, individuals with high food craving may be at greater risk of engaging in a cycle of dietary restraint and overeating.

F038: The Role of Stress During Pregnancy as an Early Risk Factor for Anorexia Nervosa: A Controlled Study

Elena Tenconi, PhD; PsyD, Department of Neuroscience, University of Padova, Padova, Italy, Daniela Degortes, PhD; PsyD, Department of Neuroscience, University of Padova, Padova, Italy, Elisa Bonello, PsyD, Department of Neuroscience, University of Padova, Padova, Italy, Tatiana Zanetti, PsyD, Department of Neuroscience, University of Padova, Padova, Italy, Manuela Soave, PsyD, Department of Neuroscience, University of Padova, Padova, Italy, Marco Del Tenconi, MD, Department of Neuroscience, University of Padova, Padova, Italy, Paolo Santonastaso, MD, Department of Neuroscience, University of Padova, Padova, Italy, Angela Favaro, MD; PhD, Department of Neuroscience, University of Padova, Padova, Italia

The literature shows that early risk factors, such as pregnancy complications and prenatal stress exposure, may have a role in the development of psychiatric disorders. Our study aims to investigate the impact of prenatal stressful experiences exposure on the development and clinical profile of anorexia nervosa. The study sample was composed of 109 patients with a lifetime diagnosis of anorexia nervosa (according to DSM-5 criteria), recruited at the Eating Disorders Unit of the Hospital of Padova, Italy, and 118 unaffected healthy controls recruited from the general population. All participants underwent a broad clinical and neuropsychological battery, in addition to clinical interviews and questionnaires. All the mothers of patients and controls underwent a specific interview tailored for this study, concerning in detail the presence of stressful life events that occurred during the pregnancy period. In addition, all obstetric and neonatal medical records were consulted. The mothers of patients experienced more, and subjectively more severe stressful episodes than the mothers of controls (Z=3.65; p=.001, Z=3.71; p=0.001). While in the mothers of controls the severity of stressful events during pregnancy was significantly associated with the outcome of pregnancy, in the mothers of patients only perceived distress during pregnancy showed significant positive correlation with both total number of obstetrical complications and placental weight. In patients, the severity of stressful events was significantly associated to cognitive rigidity and perseveration. Our data suggests that prenatal stress exposure might be a risk factor for the development of AN.

F039: The Influence of Social Media on Body Image: Considering School Environment as a Protective Factor

Blair Burnette, BA, Virginia Commonwealth University, Richmond, Virginia, Melissa Kwitowski, MS, Virginia Commonwealth University, Richmond, Virginia, Suzanne Mazzeo, PhD, Virginia Commonwealth University, Richmond, Virginia

Sociocultural models of body dissatisfaction posit that media, peers, and parents transmit messages about appearance that heighten the risk of body dissatisfaction. Although the impact of television and magazine exposure is well-researched, social media are relatively new and rapidly evolving. Additionally, most research on social media has focused on teens and young adults. Little is known about the effects of social media on body dissatisfaction in early adolescents. However, because peer influence becomes more powerful as children enter adolescence, and social media typically involves intensive peer interaction, it is important to study the impact of social media on this age group. This study used focus groups to examine the influence of social media on social comparison, thin-ideal internalization, and body dissatisfaction in 7th and 8th grade females (n = 38) from a private, single-sex school. Students indicated that the supportive school environment communicated messages that attenuated some potentially harmful effects of social media. Students perceived themselves as less likely than peers from outside the school environment to engage in appearance-based social media activities (e.g., taking “selfies”), and less likely to make appearance-based social comparisons. They also endorsed relatively high confidence and low body dissatisfaction. Results suggest that school environment might buffer some of the potentially harmful effects of social media for early adolescent females. Given the high rates of social media use in this age group, further evaluation of the potential of the school environment to serve as a protective factor could inform the design of prevention and intervention strategies.

F040: Exploring Gender Differences in the Link Between Weight Suppression and Eating Pathology

Blair Burnette, BA, Virginia Commonwealth University, Richmond, Virginia, Courtney Simpson, MS, Virginia Commonwealth University, Richmond, Virginia, Suzanne Mazzeo, PhD, Virginia Commonwealth University, Richmond, Virginia

Weight suppression, defined as the difference in an individual’s highest adult weight and current weight, has implications for the onset, maintenance, and treatment of eating disorders. Although men are more likely to have a history of overweight and often present to treatment at higher BMIs than their female peers, previous research has not examined if gender moderates the association between weight suppression and dimensions of eating pathology. The purpose of this study was to examine gender differences in the relations between weight suppression and dietary restraint, compensatory behaviors, and loss-of-control eating in an undergraduate sample. University students (n = 828, 71.7% female) completed surveys assessing demographics, weight history, and eating attitudes and behaviors. Weight suppression was significantly associated with dietary restraint and compensatory behaviors, but not loss-of-control eating, in the total sample. Gender did not significantly moderate the link between weight suppression and loss-of-control eating. The additive effects of gender and weight suppression were significantly associated with dietary restraint, but the interaction term did not reach statistical significance. Yet, gender significantly moderated the association between weight suppression and compensatory behaviors, such that men higher in weight suppression engaged in more compensatory behaviors. The association for women was not statistically significant. Results indicate that weight suppression influences dietary restraint and compensatory behaviors in a non-clinical sample. Further, findings suggest that weight history might be particularly important to consider when identifying and treating men who engage in these behaviors.

F041: Impact of integrating Complementary and Alternative Medicine Therapies into Multi-Family Group Setting for Children and Adolescents with Eating Disorders

Mindy Solomon, PhD, University of Colorado School of Medicine & Children's Hospital Colorado, Denver, Colorado, Katherine Reed, LPC; ATR, Childrens Hospital Colorado, Denver, Colorado, Heather Kennedy, MPH, UC Denver, Denver, Colorado

Complementary Alternative Medicine (CAM) therapies might be effective for families with eating disorders particularly in targeting high levels of expressed emotion. These therapies can access deeper level dynamics by providing safe, experiential opportunities for families to access deeper emotional connection within and among family members. There is no known research specifically evaluating the use of CAM therapies in multi-family groups. The clinical implications of using CAMS in multi-family groups are exciting and provide a promising avenue to target effective change in families struggling with eating disorders. A total of 812 surveys were administered over 12 months to 118 child/adolescents patients between the ages of 7-18 admitted to a children's hospital eating disorder program in Colorado. Data were collected following a 90 minute multi-family therapy session which incorporated either dance movement, art therapy, yoga therapy or music therapy (rotated weekly). Participants were asked to rate agreement on achieving 4 CAM goals - safe expression of authentic emotion; families to receive support from staff and each other to decrease sense of isolation, explore family dynamics to develop insight and work toward problem-solving, explore and model effective parent-child communication, including empathy, limit-setting, & validation. Subjective comments were coded as “general positive feedback”, “general negative feedback.” Patients had at least one family member (on average) present for the groups -44.9% were mothers, 13.4% were fathers, and 5.9% were other family (including siblings, aunts, and grandparents) and friends. Results indicate that overall, patients and family members felt the CAM goals were met with all 4 modalities () with dance movement consistently receiving the largest percentage of “strongly agree” with CAM goals. Additionally, 46.9 % of respondents included “general positive feedback,” compared to 6.9% who reported “general negative feedback.” The data are discussed as the CAM goals relate to general goals for family based treatment for eating disorders and provide a promising alternative intervention for targeting underlying family dynamics which are known to contribute to outcome/prognosis for recovery for children/adolescents with eating disorders.

F042: Evidence-Based Psychotherapy for Treatment of Anorexia Nervosa in Children and Adolescents: Systematic Review

Alicia Cobelo, MS; FAED, Institute of Psychiatry,University of São Paulo School of Medicine, Sao Paulo, Sao Paulo, Felipe Alckmin-Carvalho, MS, Institute of Psychiatry, University of São Paulo School of Medicine, Sao Paulo, Sao Paulo, Juliana Vega, MS, Institute of Psychiatry, University of São Paulo School of Medicine, Sao Paulo, Sao Paulo, Alessandra Fabbri, MS, Institute of Psychiatry, University of São Paulo School of Medicine, Sao Paulo, Sao Paulo, Vanessa Pinzon, MS, Institute of Psychiatry, University of São Paulo School of Medicine, Sao Paulo, Sao Paulo

Few clinical trials have evaluated the efficacy of psychotherapy in treatment of anorexia nervosa (AN) in children and adolescents. Systematic reviews on this topic are needed. We evaluated the efficacy of evidence-based psychological interventions in the treatment of AN among children and adolescents. The literature search was conducted in July 2016 in the following databases: PUBMED, PsycINFO, and Cochrane, using these combined keywords: cognitive behavior therapy AND anorexia nervosa and evidence-based therapy AND anorexia nervosa. The literature search was carried out independently, by two researchers experts in eating disorders. Articles published from 1990 to 2015 were evaluated. Sixteen from 139 article were selected. The interventions used were: Family-Based treatment (FBT), Behavioral Family Systems Therapy (BFST), Adolescent Focused Individual Therapy (ASF), Cognitive Behavior Therapy (CBT), Cognitive Behavior Therapy Enhanced (CBT-e), Systematic Family Therapy (SyFT), and Acceptance-based Separated Family Treatment (ASFT). The FBT is the most widely tested model, with total remission rate ranging between 20% - 49% of participants (who had begun treatment). Such result is similar or slightly higher than those found in other interventions. In terms of cost/benefit, the FBT shows better results because it is associated with faster weight restoration, and therefore, fewer days of hospitalization. FBT is considered the first-line treatment for AN in children/adolescents. Even in FBT, there was complete remission in less than half of patients who began treatment. Such result indicates the importance of developing new research’s protocols in psychotherapy in this area. These new protocols should integrate the components of FBT to maintainers variables of AN among children and adolescents, widely reported in the literature, such as deficits in parents social and educational skills. Different remission criteria used in each study makes difficult the comparison between studies. Other limitations will be analyzed.

F043: Self-Weighing and Eating-Disorder Psychopathology among Sleeve Gastrectomy Patients with Loss-of-Control Eating

Rachel Barnes, PhD, Yale School of Medicine, New Haven, Connecticut, Valentina Ivezaj, PhD, Yale School of Medicine, New Haven, Connecticut, Carlos Grilo, PhD, Yale School of Medicine, New Haven, Connecticut

The present study examined the frequency of self-weighing among bariatric surgery patients with disordered eating and examined group differences in eating-disorder psychopathology and body mass index (BMI) based on weighing frequency. Participants were 69 (84.1% female; 59.4% White) sleeve gastrectomy patients assessed 6-months post-operatively who reported loss-of-control (LOC) eating at least once weekly during the past month. Mean age and BMI were 47.3 (SD=10.3) and 37.1 (SD=6.8), respectively. LOC eating and eating-disorder psychopathology were assessed using the Eating Disorder Examination (EDE)-Bariatric Surgery Version, which also measured self-weighing behaviors and frequency. During the prior 28 days, 24.6% (n=17) never weighed, 14.4% (n=10) weighed less than once per week, 10.1% (n=7) weighed once per week, 5.8% (n=4) weighed twice per week, 24.3% (n=17) weighed more than twice per week, and 20.3% (n=14) weighed daily. Self-weighing was significantly correlated with eating-disorder psychopathology (EDE global scores) (r=.316, p=.008), but not with current BMI (r=-.163, p=.181), pre-surgical BMI (r=-.048, p=.698), or percent excess weight loss (r=.114, p=.357). Participants who weighed themselves more than once weekly reported significantly greater EDE global scores (p=.033) than participants who weighed themselves once weekly or less; BMI did not differ significantly between the two groups(p=.412). Participants who weighed themselves daily had significantly greater EDE global scores (p=.039) than participants who never weighed themselves. Our findings suggest that, among sleeve gastrectomy patients with LOC eating post-operatively, greater self-weighing is associated with greater eating-disorder psychopathology but not with BMI or weight loss after surgery. Future research with larger samples and longer follow-ups should investigate optimal weighing frequencies among individuals with disordered eating following bariatric surgery.

F044: Group Psychotherapy for Eating Disorders: A Meta-Analysis

Renee Grenon, BA; MA, University of Ottawa, Ottawa, Ontario, Dominique Schwartze, DiplPsych, Institute of Psychosocial Medicine and Psychotherapy, University Hospital Jena, Jena, Thuringia, Nicole Hammond, BA; MA, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Iryna Ivanova, BA; PhD, Department of Psychology, The Ottawa Hospital, Ottawa, Ontario, Nancy Mcquaid, BA; PhD; Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Genevieve Proulx, BSc; MD, Department of Psychiatry, University of Ottawa, Ottawa, Ontario, George Tasca, BA; MA; PhD, School of Psychology and Department of Psychiatry, University of Ottawa, Ottawa, Ontario,

In the current meta-analysis we review the effect of group psychotherapy compared to both wait-list controls and other active treatments for eating disorders. Evaluating the efficacy of various treatment options for eating disorders is important and necessary to inform both treatment guidelines, and clinicians’ practices. The number of randomized controlled trials (RCTs) that investigate the efficacy of group psychotherapy for eating disorders have increased, and results have been promising. Twenty-seven RCTs with a total of 1,853 participants were included in this meta-analysis. Effect size data for primary (abstinence rates, bingeing and/or purging frequency, and eating disorder psychopathology) and secondary (depressive symptoms, self-concept, and interpersonal problems) outcomes were extracted. All RCTs were rated on methodological quality. Results indicated that group psychotherapy is significantly more effective than wait-list controls at achieving abstinence rates of binge-eating and/or purging, decreasing the frequency of binges and/or purges, and reducing eating disorder psychopathology after treatment. The effects of group psychotherapy and other active treatments (e.g., behavioral weight loss, self-help, individual psychotherapy etc.) did not differ on any outcome at post-treatment, at short-term follow-up (≤ 6 months), or at long-term follow-up (> 6 months). Group cognitive behavioral therapy (CBT) and other forms of group psychotherapy did not differ significantly on outcomes at any time point. Additional research is needed to evaluate other group psychotherapy approaches, along with CBT, in order to provide more evidence-based treatment options for individuals with an eating disorder. Group psychotherapy appears as effective as other common treatments and is perhaps more cost-effective than the most popular treatment, individual psychotherapy.

F045: A Conservative Refeeding Approach in Female Inpatients with Restrictive Eating Disorders is not Protective of Refeeding Syndrome

Shane Jeffrey, BSc; RD, Grad Dipl, Royal Brisbane Women's Hospital, Metro North Mental Health, Brisbane, Queensland, Elsie Patterson, BSc; Student, University of the Sunshine Coast, Maroochydore, Queensland, Tetyana Rocks, BSc, University of the Sunshine Coast, Maroochydore, Queensland, Hattie Wright, BSc; MSc; PhD; RD, Grad Dipl, University of the Sunshine Coast, Maroochydore, Queensland 

The purpose of this study was to describe the effect of a conservative refeeding protocol on rates of hypophosphatemia, hypokalaemia, hypomagnesemia and hypoglycaemia in female inpatients with restrictive eating disorders and explore differences in measured variables in patients reaching medical stability at different stages of hospitalisation. Historical medical records of female, adult patients admitted for treatment from January 2010 to December 2013 were retrospectively reviewed. Demographic characteristics, anthropometric measures, energy prescription and presence of hypophosphatemia (≤0.81mmol/L), hypokalaemia (≤3.5mmol/L) hypomagnesemia (≤0.7mmol/L) and hypoglycaemia (≤4.0mmol/L) at day 1 (admission), day 3, day 7 and day 14 were recorded. Twenty seven female patients were included, mean age 33 (20;35) yrs. Medical stability was reached at 18.6 ± 10.3 days, 63% (n=17/27) reached medical stability ≤14 days of hospitalisation. In the total group, hypoglycaemia (59%, n=16), hypokalaemia (56%, n=15), hypophosphatemia (44%, n=12) and hypomagnesemia (19%, n=5) developed primarily after day 3. Patients who reached medical stability

F046: Food Addiction in Bulimia Nervosa: Clinical Correlates and Association with Response to a Brief Psychoeducational Intervention

Fernando Fernández-Aranda, PhD, University Hospital of Bellvitge-Idibell, Ciberobn, Hospitalet de Llobregat, Barcelona, Inés Hilker, PhD, Hospital Clínic of Barcelona, Barcelona, Barcelona, Isabel Sánchez, PhD, University Hospital of Bellvitge- Idibell, Hospitalet de Llobregat, Barcelona, Trevor Steward, MSc, University Hospital of Bellvitge- Idibell, Ciberobn, Hospitalet de Llobregat, Barcelona, Susana Jiménez-Murcia, PhD, University Hospital of Bellvitge- Idibell, Ciberobn, Hospitalet de Llob, Barcelona, Roser Granero, PhD, Universitat Autònoma de Barcelona, Ciberobn, Barcelona, Barcelona, Ashley N Gearhardt, PhD, University of Michigan, Ann Arbor, Michigan, Rita Cristina Rodríguez-Muñoz, MSc, University Hospital of Bellvitge, Hospitalet de Llob, Barcelona, Carlos Dieguez, MD; PhD, University of Santiago de Compostela-Instituto de Investigación Sanitaria, Ciberobn, Santiago de Compostela, A Coruña, Ana Belén Crujeiras, PhD, Complejo Hospitalario Universitario de Santiago de Compostela, CIBEROBN, Santiago de Compostela, A Coruña, Iris Tolosa-Sola, MSc, University Hospital of Bellvitge, Hospitalet de Llob, Barcelona, Felipe F Casanueva, MD; PhD, Complejo Hospitalario Universitario de Santiago de Compostela, Ciberobn , Santiago de Compostela, A Coruña, José M Menchón, MD; PhD, University Hospital of Bellvitge-Idibell, Cibersam, Hospitalet de Llobregat, Barcelona

Food addiction (FA) has been examined in different populations. Although high FA levels are associated with greater eating-disorder severity, few studies have addressed how FA relates to treatment outcome. Therefore, the goals of the present study were: (1) to determine whether a brief intervention for bulimia nervosa (BN) reduces FA diagnosis or severity compared to baseline; and (2) to determine if FA is predictive of treatment outcome. 66 female BN patients participated in the study. The Yale Food Addiction Scale was administered at two time points: prior to- and following a 6-week intervention. The number of weekly binging/purging episodes, dropout and abstinence from bulimic behavior were used as primary outcome measures. The results showed that this brief intervention reduced FA severity and FA diagnosis in the 55 patients who completed treatment. FA severity was a short-term predictor of abstinence from binging/purging episodes after treatment (p=.018). In conclusion, FA appears to be prevalent in BN although FA severity can improve following a short-term intervention.

F047: Mediators of the Relationship between Weight Stigma Concerns and Disordered Eating in Bariatric Surgery Patients

Aliza Friedman, MA; PhD Student, Department of Psychology, Ryerson University, Toronto, Ontario, Susan Wnuk, PhD, Toronto Western Hospital, Bariatric Surgery Program, Toronto, Ontario, Sanjeev Sockalingam, MD, Toronto Western Hospital, Bariatric Surgery Program, Toronto, Ontario, Stephanie Cassin, PhD, Department of Psychology, Ryerson University, Toronto, Ontario

The relationship between weight stigma and disordered eating has been well documented in obese populations; however, the mechanisms underlying this association remain unclear. The purpose of this study was to examine body shape concerns and general psychological distress as potential mediators in the relation between weight stigma concerns and two facets of disordered eating (binge eating and emotional eating) in pre-operative bariatric surgery patients. Adult bariatric surgery patients (N = 103, Mage = 42.32, MBMI = 49.31kg/m2) completed a series of questionnaires assessing weight stigma concerns, psychological distress, body shape concerns, binge eating, and emotional eating (eating in response to anger/frustration, anxiety, and depression) as part of an ongoing research study at the Toronto Western Hospital, Bariatric Surgery Program. Results revealed that bariatric surgery patients who reported concerns about being stigmatized for their weight/shape were at an elevated risk for both binge eating and emotional eating in response to anger/frustration and anxiety, but not for emotional eating in response to depression. Using nonparametric bootstrapping analyses, body shape concerns emerged as a significant mediator in the relations between weight stigma concerns, binge eating, and emotional eating in response to anger/frustration. With respect to emotional eating in response to anxiety and depression, the combined total effect of body shape concerns and psychological distress emerged as a significant mediator of these relations; however, neither variable was a significant independent mediator. Taken together, these results demonstrate that body shape concerns emerged as the most relevant explanatory mechanism in the relation between weight stigma concerns and disordered eating, highlighting that reducing body shape concerns should be considered an important treatment target within disordered eating interventions in pre-surgical bariatric surgery patients.

F048: Effects of Exposure to Weight Concerned and Non-Weight Concerned Others on Body Image, Eating and Self-Attitudes

Kathryn Miller, BSc; MA, University of Waterloo, Waterloo, Ontario, Allison Kelly, BA; PhD, University of Waterloo, Waterloo, Ontario

Research firmly illustrates the detrimental correlates of being exposed to others who are overly concerned with their body shape and/or weight. However, there is virtually no research on how exposure to non-weight concerned others affects one’s body image and eating. Thus the present study investigated the unique contributions of exposure to weight preoccupied and non-weight preoccupied others to young women’s eating, body image, and global self-attitudes, both between-persons and within-persons. For one week, 92 female college students completed nightly online questionnaires. Multilevel modelling revealed that at the between-persons level, college women who reported a higher average level of exposure to non-weight preoccupied over the week generally reported more intuitive eating, less dietary restraint, more body appreciation, higher self-esteem, and higher self-compassion. Women with higher average levels of exposure to dieters reported less intuitive eating, more dietary restraint, less body appreciation, and higher self-criticism. At the within-persons level, on days when women were more exposed to more non-weight preoccupied eaters than usual, intuitive eating, body appreciation, and state body image were all higher. On days when exposure to dieters was higher than usual, so too was self-criticism. Finally, a higher-than-usual daily level of exposure to normal eaters was most beneficial on days when exposure to dieters was low. Findings are the first to suggest that independent of a young women’s level of exposure to dieters, her level of exposure to normal eaters – both on a given day and across days – contribute to eating habits, body image, and self-attitudes. Practically, results suggest that encouraging young women to cultivate social environments that minimize exposure to weight concerned others and maximize exposure to non-weight concerned others may help them maintain adaptive eating habits and body image, and encourage generally positive self-relating.

F049: Sociocultural Influences on Body Dissatisfaction in Adolescent Males

Rosalia Vazquez-Arevalo, PhD, Universidad Nacional Autónoma de México, Mexico, Ciudad de Mexico, Maria de los Angeles Alcantara Lopez, CPsychol, National Autonomous University of Mexico, Mexico City, APO AE, Xochitl Lopez Aguilar, PsyD, National Autonomous University of Mexico, Mexico City, APO AE, Juan Manuel Mancilla-Diaz, PhD, Universidad Nacional Autonoma de Mexico, Mexico, Ciudad de Mexico

Body dissatisfaction arises at the time that the individual exceeds the regulatory discomfort and their body dissatisfaction leads him to harmful health behaviors. The purpose of this research was to investigate the peer influence, BMI and internalization of the aesthetic model on body dissatisfaction adolescent males. Participants were 143 male students with an average age of 12.9 (SD 1.1), who underwent an anthropometric measurement and answered a battery of tests that included: Questionnaire of Sociocultural Influence on the Aesthetic Body Shape Model (CIMEC), Peer influence Inventory on Food Concern (I-PIEC), Drive Muscularity Scale (DMS), Body Modification Scale (BMS), Muscular and grease Silhouettes Scale (MSM and FSM). All participants who presented body dissatisfaction and also a similar number of controls were interviewed. In the data analysis 9.8% of participants had body dissatisfaction mainly include young people with normal-weight, 92.3% of the participants chose the muscular silhouettes as ideal, the results obtained by multiple linear regression show that 38% of the variance was explained in the influence of peer comments (β = .40 p <.01) and pro-muscled body modification strategies (β = .45 p <.01). The exercise was the main risk factor for body dissatisfaction in men aged 12 to 14 years.

F050: The Effects of Cognitive Dissonance and Weight Stereotype Activation on Internalization of Weight Bias and Food Consumption

Suman Ambwani, PhD, Dickinson College, Carlisle, Pennsylvania, Cai Guo, BA, Stanford University, Stanford, California, Lea Simms, BA, Dickinson College, Carlisle, Pennsylvania, Emily Abromowitz, Student, Dickinson College, Carlisle, Pennsylvania

Although research suggests that internalization of weight bias (i.e., self-endorsement of negative weight stereotypes) is linked with multiple forms of psychopathology and is distinct from anti-fat attitudes, there is a paucity of experimental research and the factors impacting weight bias internalization and their behavioral sequelae remain unclear. The present experimental study thus examined the impact of exposure to stereotypes about obesity (i.e., exposure to stereotypical vs. non-stereotypical images) and cognitive dissonance (i.e., forced counter-attitudinal vs. non counter-attitudinal thinking) on college women’s (N=97) internalization of weight bias, anti-fat attitudes, and food consumption behaviors. Although the stereotypical and non-stereotypical images were obtained from previous research, the materials for the cognitive dissonance manipulation were novel and thus tested in a pilot study (N=18). Data collection sessions were administered in individual study rooms wherein participants completed computerized measures while consuming a selection of snacks as part of an ostensible taste test. Results from a 2x2 factorial ANOVA (controlling for participant BMI) indicated a significant main effect for stereotype activation on weight bias internalization; the main effect for cognitive dissonance and the interaction term were not significant. Analyses testing the impact of the experiment on anti-fat attitudes and food consumption behaviors were not statistically significant. Current findings offer experimental evidence that internalization of weight bias is indeed distinct from anti-fat attitudes. These data also suggest that exposure to weight-stereotypical images exerts a potent effect that may be difficult to change through cognitive dissonance interventions. Future studies may evaluate alternate cognitive dissonance strategies and the impact of different types of stereotypes on individuals varying across dimensions of weight status and eating psychopathology.

F051: Perfectionism, Depression and Obsessivity in a Sample of Adolescents with Anorexia Nervosa or Obsessive-Compulsive Disorder

Itziar Flamarique, MD; PhD, Hospital Clínic de Barcelona, Barcelona, Barcelona, Josefina Castro-Fornieles, MD; PhD, Hospital Clínic de Barcelona, Barcelona, Barcelona, Maria Teresa Plana, MD, Hospital Clínic de Barcelona, Barcelona, Barcelona, Elena Moreno, PsyD, Hospital Clínic de Barcelona, Barcelona, Barcelona, Luisa Lazaro, MD; PhD, Hospital Clínic de Barcelona, Barcelona, Barcelona

The aim of the study was to investigate the relationship of two perfectionism dimensions (self-oriented perfectionism and socially prescribed perfectionism) with obsessive and depressive symptoms and study whether any dimension of perfectionism was specific to Anorexia Nervosa (AN) or Obsessive-Compulsive Disorder (OCD) compared to healthy controls in a sample of adolescents. The sample consisted of 79 adolescents with AN, 32 with OCD and 76 healthy controls. Perfectionism was assessed with the Child and Adolescent Perfectionism Scale (CAPS). The CAPS has two dimensions, the self-oriented perfectionism (SOP) and the socially prescribed perfectionism (SPP). They were also assessed with the Leyton Obsessional Inventory-Child Version (LOI-CV) and the Childhood Depression Inventory (CDI). The AN group showed higher scores on the SOP and the CDI compared to the OCD and control groups (p<0.001). With regard SPP, no differences were observed between the AN group and the OCD group or the control group. Mean total scores of LOI-CV were higher for both the AN group and the OCD group than the Control group (p<0.001). The interaction between group and SOP regarding the LOI-CV was statistically significant between the AN group and the Control group (p=0.013).For each point increased in the SOP, belonging to the AN group was associated with an increase of 0.41 points on the LOI-CV compared to the control group. With regard SOP and CDI, there was a significant interaction between group and SOP to explain depressive symptomatology, also for the AN group compared to the control group (p=0.002). For each point increased in the SOP, if you belonged to the AN group, an increase of 0.35 was observed in the CDI compared to the control group. No interaction was found between SPP and group regarding depressive or obsessive symptoms. To summarize, self-oriented perfectionism seemed more specific to AN than to OCD compared with controls in a sample of adolescents, whereas socially prescribed perfectionism did not show differences between groups. Moreover, belonging to the AN group implied that self-oriented perfectionism was associated with more severe depressive and obsessive symptoms than healthy controls.

F052: Do Food Attitudes Differ Across Adolescence?

Arielle Wolinsky, BA; MA, Rutgers, The State University of New Jersey, Camden, New Jersey, Charlotte Markey, PhD, Rutgers, The State University of New Jersey, Camden, New Jersey

This study investigated the relations between age and individuals’ food attitudes; gender, weight status, and body satisfaction were explored as moderators. It was hypothesized that there would be an overall negative correlation between age and food attitudes with older participants having less healthy attitudes about food; this relation was expected to be stronger for girls than boys. Adolescents (N = 1107, Mage = 15.58 years) from a public high school completed self-report questionnaires assessing their age, gender, weight status, body satisfaction, and food attitudes. Contrary to our expectations, results indicated that older adolescents experienced greater pleasure from food than younger adolescents. Further, adolescents’ weight status predicted decreased pleasure from food and increased weight concerns. We did not find a significant difference in weight concerns for younger versus older boys regardless of weight status; however, there was a significant difference in weight status for younger versus older girls, regardless of weight status. These results suggest that to understand an adolescent’s eating attitudes and weight concerns, age, weight status, and gender need to be considered. These findings may have application in the creation of interventions to address food attitudes that may contribute to preventing the development of disordered eating attitudes and behaviors among adolescents.

F053: Insidious: the Relationship Between Patients and their Eating Disorders and its Dmpact on ED Symptoms, Illness Duration and Self-image

Emma Forsén Mantilla, MSc, Karolinska Institute, Stockholm, Sweden, Andreas Birgegård, PhD, Karolinska Institute, Stockholm, Sweden

Patients with eating disorders (EDs) often spontaneously talk about their disorder in terms of a symbolic other (a demon, a voice, a guardian). Further, externalizing exercises where patients are encouraged to separate their true self from their ED self are common in some treatment approaches. Yet, no previous quantitative study has investigated this phenomenon. We examined the patient-ED relationship (using the interpersonal Structural Analysis of Social Behavior methodology) and its implications for ED symptoms, illness duration and self-image. Participants were 16-25 year old female patients (N=150) diagnosed with anorexia nervosa (N=55), bulimia nervosa (N=33) or eating disorder not otherwise specified (N=62). Results suggested that patients had comprehensible and organized relationships with their EDs. EDs were primarily experienced as acting critical and controlling towards patients. Higher ED control was associated with more ED symptoms and longer illness duration, especially when coupled with patient submission. Patients reacting more negatively towards their EDs than their EDs were acting towards them had lower symptom levels and more positive self-images. Externalizing one’s ED, relating to it like a symbolic seemed to make sense to patients and depending on its quality seemed to influence ED symptoms, illness duration and self-image. We put forward both clinical and theoretical implications based on the assumption that the patient-ED relationship may function in similar ways as real-life interpersonal relationships do.

F054: Does Duration Matter? Clinical Impairment as Predicted by Length of Dietary Restricting

Danielle Chapa, BA; Student, University of Kansas, Lawrence, Kansas, Brittany Bohrer, MA; Student, University of Kansas, Lawrence, Kansas, Kelsie Forbush, PhD, University of Kansas, Lawrence, Kansas

More severe than “dieting,” dietary restricting (DR) to maintain low weight or to compensate for binge-eating episodes is associated with marked distress and psychosocial impairment. Despite recognition that DR is a clinically important eating disorder (ED) symptom, clinical and research perspectives of DR vary widely. Definitions of DR include: 1) meal skipping, 2) restricting for eight or more waking hours, or 3) restricting for 24 hours or longer. The purpose of this study was to test which temporal definition of DR was most highly associated with clinical impairment and binge eating in a sample of adults with a DSM-5 ED (N=204; 81.4% women). Semi-structured clinical interviews were administered to assess what and when participants ate on DR days. Duration of DR was calculated by identifying the number of consecutive hours that participants ate considerably less than what would be expected based on their age, sex, BMI, and activity level. Linear regression showed that the number of DR hours and meal skipping did not predict clinical impairment or the number of binge-eating episodes. However, ANOVA analyses indicated that participants who engaged in DR for 24-hours were significantly more clinically impaired compared to those who restricted for eight-hours or less. In conclusion, our findings support cognitive-behavioral interventions that promote helping clients establish regular eating patterns. Although there were few differences between definitions of DR for predicting binge eating, restricting for a full day was associated with greater ED-related clinical impairment. Clinicians and researchers should consider inquiring about length of dietary restriction, with particular attention to persons who engage in day-long periods of inadequate intake. Future research is needed to understand whether 24-hour definitions of restricting out-predict other definitions of DR for understanding clinical course, prognosis, and diagnostic recurrences.

F055: Clinical Features of Males with Anorexia Nervosa in Japan

Tomoko Harada, PhD, Department of Neuropsychiatry, Osaka City University, Graduate School of Medicine, Osaka, Osaka, Tuneo Yamauchi, PhD, Department of Neuropsychiatry, Osaka City University, Graduate School of Medicine, Osaka, Osaka, Yuya Kodama, MD, Department of Psychiatry, Osaka City Kousaiin Hospital, Osaka, Osaka, Saori Miyamoto, MD, Department of Neuropsychiatry, Osaka City University, Graduate School of Medicine, Osaka, Osaka, Kazuya Nishimoto, MD, Department of Neuropsychiatry, Osaka City University, Graduate School of Medicine, Osaka, Osaka, Koki Inoue, PhD, Department of Neuropsychiatry, Osaka City University, Graduate School of Medicine, Osaka, Osaka

Anorexia nervosa (AN) is psychiatric disease with a high mortality rate, and progresses to a serious state, even in males; however the characteristics of male AN patients, including the sex ratio in Japan and the consultation behavior, have not yet been clarified. Therefore, we investigated the clinical characteristics of Japanese male AN patients, with the aim of achieving early interventions. A total of 2,015 AN patients, 60 males and 1,955 females, were extracted from 4,606 eating disorder patients who consulted Osaka City University Hospital for 34.5 years. The sex ratio was examined, and clinical features, mainly those related to consultation behavior, were compared between males and females. The male ratio in AN patients was 3.0 %. No significant sex difference was noted in the mean age at the time of consultation and delays in treatment. The rate of weight loss from the premorbid to lowest body weight was similar between males and females. Regarding social backgrounds, the employment rate was higher in males than in females. Male AN patients were more likely to initially consult the psychiatry department. The male ratio in Japanese clinical AN patients was low and markedly lower than generally considered. Consultation behavior may be restricted in males more than that in other countries because eating disorders are considered to be female diseases in Japan. The weight loss rate of male AN is physically high, similar to female AN; therefore, early interventions were considered important. Educational programs for eating disorders not only in the general public, but also in schools and companies may promote early interventions.

F056: Risk for Disordered Eating in Heterosexual and Sexual Minority Women: Examining the Role of Relationship Status, Relationship Satisfaction, and Sexual Identity

Elizabeth Velkoff, BA, Miami University, Oxford, Ohio, Aimee Yeager, BA, Miami University, Oxford, Ohio, April Smith, PhD, Miami University, Oxford, Ohio

The present study examined the role of relationship factors, sexual identity, and unique sexual minority (SM) experiences in association with eating disorder (ED) symptoms among women. A sample of heterosexual (n = 48) and SM (n = 51) women completed several self-report questionnaires online. Research finds that romantic relationships may protect against ED symptoms among SM men, and satisfying romantic relationships have been shown to protect against other negative mental health outcomes among SM women. Additionally, uncertainty about one’s sexual identity may confer risk for poorer mental health outcomes. Finally, SM-specific experiences may play a unique role in risk for ED behaviors among SM women. Given these previous findings, we tested the following hypotheses: (1) single SM women would have more ED symptoms than single heterosexual women, but partnered heterosexual and SM women would not show differences in ED symptoms, (2) greater relationship satisfaction would predict fewer ED symptoms for all women, but the negative association would be stronger for SM women than heterosexual women, (3) greater discrepancy between sexual orientation identity, sexual attraction, and sexual behavior would be related to higher ED symptoms, and (4) among the sample of SM women, some factors unique to SM individuals (i.e., acceptance concerns and identity uncertainty) would positively relate to more ED symptoms, whereas other unique factors (i.e., identity affirmation) would negatively relate to ED symptoms, serving as protective factors. Results indicated that there was not a significant interaction of sexual orientation and relationship status in the prediction of ED symptoms, and greater relationship satisfaction was associated with fewer ED symptoms among both heterosexual and SM women. We found that greater discrepancy between sexual identity and attraction was associated with more ED symptoms. Finally, our results indicated that fear of stigma is associated with greater ED symptoms among SM women.

F057: Eating Disorders Among Collegiate Rugby Players in Argentina: An Exploratory Study

Emilio J. Compte, PhD, Favaloro University, Buenos Aires, Buenos Aires, Sofia Schweiger, Student, Favaloro University, Buenos Aires, Buenos Aires, Michelle Bressan, Student, Favaloro University, Buenos Aires, Buenos Aires

In recent years interest in understanding the features of eating disorders (EDs) in males has increased. More specifically, athletes have been considered an at risk population given their exposure to several risk factors such as competitive anxiety, past injuries, food supplement intake, a positive attitude towards performance-enhancing substances and steroids use, and the exposure to the cultural body ideal, among others. However, previous research has mainly focused on sports that emphasize leanness, and was conducted in developed countries. The main aim of this study was to evaluate the psychological features of collegiate rugby players in Buenos Aires (Argentina) at risk for EDs, compared with rugby players who are not at risk. For that purpose, athletes completed a survey during their training sessions that included the Eating Disorders Examination-Questionnaire, Exercise Dependence Scale, Emotion Regulation Questionnaire, Performance Enhancement Attitude Scale, Physical Appearance Comparison Scale, Competitive State Anxiety Inventory, and questions about their height, current and desired weight, attitudes towards steroid use, supplement intake, position in the field (forward or back), and history of past injuries. From the 203 Rugby players that completed the survey, 8.9% (n=18) were found to be at risk for EDs. Players at risk showed higher desired BMI, and also higher levels of physical comparison, exercise dependence and competitive anxiety. A multiple regression analysis showed that attitudes towards steroids and performance-enhancing substances, food supplement intake, current BMI, physical comparison, and competitive anxiety were predictors of EDs among rugby player, and together these variables accounted for 55% of the variance. We hope that the availability of this data will enhance our understanding of EDs among athletes and will contribute to healthy practices in support of sports performance and health.

F058: To go or not to go: Food-Specific Inhibition Training in Bulimia Nervosa

Bruno Nazar, MSc; MD; PhD, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil, Robert Turton, BA, King's College London, London, UK, Emilee Burgess, BA; CPsychol, King's College London, London, UK, Natalia Lawrence, BSc; PhD, University of Exeter, Exeter, Exeter, Valentina Cardi, CPsychol; PhD, King's College London, King's College London, London, Colette Hirsch, CPsychol; PhD; Professor, King's College London, London, UK, Janet Treasure, MRCPsych; PhD; FAED, Professor, King's College London, London, UK

Impaired inhibitory control could underlie the impulsive features of Bulimia Nervosa (BN). Go/no-go paradigms have been developed to help increase inhibitory control over automatic eating impulses. However, this approach has not been tested in eating disorders. The aim of this study was to examine whether a session of food-specific go/ no-go training can help to reduce the consumption of binge-foods in BN. 22 participants with BN and 17 Healthy Controls (HCs) have taken part to date. Participants were given one session of food-specific go/no-go training and one control session, using a within-subjects AB/BA crossover design. The primary outcome measure was food consumption on a taste test following the training. A Mann-Whitney U test showed that people with BN consumed significantly less of the binge foods (i.e., chocolate and crisps) than the HCs between the experimental and control condition (p = .046, r = .32). No significant differences in the consumption of non-binge/ novel foods were found (p > .6). Preliminary results suggest that go/no-go training is helpful for people with BN in reducing the consumption of binge foods relative to HCs. We are also testing this paradigm for people with binge eating disorder. Further research with more sessions of training and long-term follow-ups is needed to ascertain whether go/ no-go training might be useful as an adjunct treatment enhancer. This could involve people uploading their own ‘trigger foods’ into the training.

F059: Eye Movements and GABA in Anorexia Nervosa: Implications for the Underlying Neurobiology of Anorexia Nervosa

Andrea Phillipou, BSc; PhD, St Vincent's Hospital, Melbourne, Victoria, Larry Abel, PhD, The University of Melbourne, Melbourne, VIC, David Castle, MD, The University of Melbourne, Melbourne, VIC, Richard Nibbs, Swinburne University of Technology, Melbourne, VIC, Matthew Hughes, PhD, Swinburne University of Technology, Melbourne, VIC, Caroline Gurvich, DPsych, Monash Alfred Psychiatry Research Centre, Melbourne, VIC, Bradford Moffat, PhD, The University of Melbourne, Melbourne, VIC, Susan Rossell, PhD, Swinburne University of Technology, Melbourne, VIC

Anorexia Nervosa (AN) is associated with the highest mortality rate of any mental illness, yet the neurobiological underpinnings of the condition remain unclear. The neurobiology involved in the production of saccadic eye movements is well understood, and saccadic eye movement tasks have been used to investigate neurobiological deficits in a range of other psychiatric populations. In our recent research, we identified distinctive eye movement abnormalities in AN indicative of neuronal disinhibition. These deficits included saccadic ‘intrusions’ during fixation, hyperscanning of stimuli, faster saccadic reaction times to peripheral stimuli and an inability to suppress eye movements to unattended stimuli. These deficits are suggestive of gamma-aminobutyric acid (GABA) dysfunction in individuals with AN. Pilot data has also been collected directly investigating GABA concentrations in different brain regions in participants with AN, those recovered from AN and healthy controls, in relation to performance on saccadic eye movement tasks. Magnetic resonance spectroscopy was performed on the superior colliculus (involved in the eye movement deficits observed in AN) and the left supramarginal gyrus (a control region). Given the overlap between behaviours related to GABAergic function and AN, including anxiety and feeding behaviour, these findings have the potential to inform the utilisation of agents that modulate GABA in the treatment of this illness.

F060: An fMRI Investigation of Implicit Processing of Food Stimuli in Anorexia Nervosa

Julius Steding, MSc; Student, Technische Universität Dresden, Dresden, Saxony, Franziska Ritschel, DiplPsych, Technische Universität Dresden, Dresden, Saxony, Daniel Geisler, Dipl.-Inf., Technische Universität Dresden, Dresden, Saxony, Joseph King, DiplPsych; PhD, Technische Universität Dresden, Dresden, Saxony, Ilka Böhm, DiplPsych, Technische Universität Dresden, Dresden, Saxony, Maria Seidel, DiplPsych, Technische Universität Dresden, Dresden, Saxony, Richard Vettermann, Student, Technische Universität Dresden, Dresden, Saxony, Johannes Zwipp, DiplPsych, Technische Universität Dresden, Dresden, Saxony, Thomas Goschke, DiplPsych; PhD, Technische Universität Dresden, Dresden, Saxony, Veit Rössner, MD, Technische Universität Dresden, Dresden, Saxony, Stefan Ehrlich, MD, Technische Universität Dresden, Dresden, Saxony

Although suffering from severe underweight, patients with anorexia nervosa continue to avoid food intake. Previous studies have shown impaired brain activation in response to food images in AN patients (Oberndorfer et al., 2013; Uher et al., 2003). In this study, we use fMRI to investigate neural correlates of reaction to food stimuli that are not in the focus of attention. This study included 32 acute AN patients (acAN) and 32 matched healthy controls (HC). Participants performed a block-designed distractor n-back (Ladoceur et al., 2009) consisting of a 2-back working memory (WM) task flanked by disorder relevant pictures (food, non-food). Performance data were analyzed with repeated measures ANOVAs. Two-sampled t-tests were used to compare whole brain activation between groups. On behavioral level, reaction times differed between conditions (food > non-food) and a trend effect for group difference occurred (HC > acAN). No differences in accuracy were found. On neuroimaging level, first, task feasibility was confirmed by robust activations of the WM-network when performing the task and a food specific network (as described by Killgore et al., 2003; Simmons et al., 2005) when comparing food against non-food pictures. Preliminary hypothesis-driven ROI analysis focusing on amygdala activity did not reveal significant group differences if applying stringent control for multiple comparisons. Psychophysiological interaction analyses revealed a reduced connectivity of amygdala with ACC for food stimuli in AN patients compared to HC, which might indicate a impaired ACC top-down regulation of amygdala reactivity for food stimuli in AN patients.

F061: Angry Rumination in Patients with Anorexia Nervosa and Bulimia Nervosa: Associations with Eating-Disorder Psychopathology, Impulsivity, and Perfectionism

Shirley Wang, Student, The College of New Jersey, Ewing, New Jersey, Ashley Borders, PhD, The College of New Jersey, Ewing, New Jersey, Elizabeth Frenkel, PhD, University Medical Center of Princeton at Plainsboro, Plainsboro, New Jersey, Melinda Parisi, PhD, University Medical Center of Princeton at Plainsboro, Plainsboro, New Jersey

Depressive rumination is significantly implicated in the onset and maintenance of eating-disorder (ED) psychopathology. Angry rumination has also been associated with ED psychopathology among nonclinical samples. However, little is known about the association between angry rumination and ED psychopathology, and other processes that influence these relationships, among individuals with clinical significant EDs. In the current study, 78 patients with anorexia nervosa (AN) or bulimia nervosa (BN) completed the eating disorder examination-questionnaire, as well as established questionnaires assessing angry rumination, depressive rumination, impulsivity, and perfectionism. Angry rumination was significantly correlated with global ED psychopathology, including restraint, eating concern, shape concern, and weight concern. Parallel mediation analyses revealed that both negative urgency and self-oriented perfectionism mediated the association between angry rumination and ED psychopathology. Moreover, negative urgency remained a significant mediator even when statistically controlling for the effects of depressive rumination. Our findings suggest that, among patients with AN or BN, angry rumination is an important cognitive process associated with severity of ED psychopathology, and that these associations can be partially explained through heightened impulsivity and perfectionism. Importantly, the effects of angry rumination persisted after accounting for depressive rumination. With further examination, findings that angry rumination plays a role in ED psychopathology could offer additional targets for prevention and treatment interventions.

F062: Do Weekly Variations in Specific Emotion Regulation Strategies and State Mindfulness have an Influence on Bulimic Symptoms? A Naturalistic Weekly Diary Study

Ines Wolz, MSc, Institute of Biomedical Research Bellvitge, Barcelona, Catalonia, Isabel Sánchez-Díaz, PhD, Hospital de Bellvitge, Barcelona, Catalonia, Roser Granero, MSc, Universitat Autónoma de Barcelona, Barcelona, Catalonia, Fernando Fernández-Aranda, PhD, Hospital de Bellvitge, Barcelona, Catalonia

Variations in binge-/purging symptomatology are related to the experience of negative emotions, but it has also been shown that the way in which emotions are dealt with, i.e. the use of emotion suppression compared to reappraisal, might be more important than the emotional event per se. This study aimed to look at the variation of state mindfulness and state use of the emotion regulation strategies reappraisal and suppression and to look at the influence of positive and negative emotions as well. Over a six week period, during psychoeducative treatment, patients with bulimia nervosa filled in a weekly protocol of measures of emotion regulation and symptomatology. Trait measures of emotion regulation did not change from baseline to post psychoeducative treatment. The most strongly felt emotions over the six-week period were anxiety, strain and sadness, sadness decreased more strongly over time. Positive emotions were reported less and to a smaller extent, the strongest positive emotions were love, amusement and joy. Canonical correlations showed a significant association between binge- and purge-symptomatology and suppression, reappraisal, mindfulness and positive and negative emotions over time. Pearson correlations showed that higher mindfulness was related to more positive and less negative emotions, and less binge-eating and purging over time. For reappraisal, associations were similar, but less strong. Suppression was related to more negative and less positive emotions, but not clearly to binge-purging symptomatology. More negative emotions and less positive emotions were related to more binge-purging symptomatology. Altogether, results show that emotion regulation and mindfulness interact dynamically with binge-purging symptomatology in everyday life.

F063: Perceptions of the Causes of Eating Disorders: A Comparison Between Mothers and Their Daughters with Eating Disorders

Valeria Soto-Fuentes, MPsych, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico, Mexico, Verónica Vázquez-Velázquez, PhD, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico, Mexico City, Ingrid Rocha-Velis, MPsych, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico, Mexico City, Lucy Reidl-Martínez, PhD, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico, Mexico City, Marcela Rodríguez-Flores, MSc, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico, Mexico City, Eduardo García-García, MD, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico, Mexico City

The aim of this study was to examine differences in perceptions regarding the causes of eating disorders among mothers and their daughters with eating disorders. Sixty dyads of mothers and daughters were grouped according with the daughter’s diagnosis of anorexia nervosa (AN) or bulimia nervosa (BN): 30 of AN (Daughters 18.2±2.9 years, BMI 16.9±3.2; Mothers 45.2±5.5 years, BMI 26.3±4.1) and 30 of BN (Daughters 19.1±3.1 years, BMI 22.2±3.2; Mothers 47.6±5.1 years, BMI 26.0±6.5). Through an open question to the mothers: “What do you think was (were) the cause(s) of your daughter eating disorder?” and to the patients: “What do you think was (were) the cause(s) of your eating disorder?”, a list of eleven codes for the causes of eating disorders was created from the responses of both mothers and daughters based on a review of the literature: body dissatisfaction, emotional/psychological factors, family factors, medical problems, obesity, aspects related to the msocial/media aspects, family attitudes to shape and weight, school factors, aspects related to father and unknown cause. Frequencies and chi square analyses demonstrated differences in rates of agreement between mothers and daughters in all causes, except when the daughter had obesity. Daughters most frequently endorsed body dissatisfaction, having obesity, social/media aspects and emotional/psychological factors, but not school, family factors and unknown causes. Mothers attributed their daughter´s eating disorder most frequently to social/media aspects, emotional/psychological factors and family factors, with body dissatisfaction, medical problems and school least endorsed. As a conclusion, the noteworthy differences between mothers and daughters suggest that there is a need for greater understanding of the etiology of eating disorders inside families, which could potentially aid the treatment process.

F064: Depression and Self-Esteem FBT vs CBT in BN

Fabiola Valenzuela, BS, Stanford University, Stanford, California, Daniel Le Grange, MA; PhD, Postdoctoral Fellowship, University of California, San Francisco, San Francisco, California

This study examines change in secondary clinical symptoms present in individuals with bulimia nervosa (BN), such as depression and low self-esteem, in a randomized clinical trial comparing Cognitive Behavioral Therapy (CBT) and Family-Based Therapy (FBT). Depressive symptoms and low self-esteem are prevalent in individuals with BN, and it is important to study how CBT and FBT impact these related clinical symptoms. While CBT is an individual therapy, the traditional CBT model primarily places greater emphasis on behavioral modulation vs. cognitive-emotional modulation. Because evidence suggests that individuals with BN with high levels of negative affect have difficulty with emotion-regulation, the traditional form of CBT may result in poorer prognosis as it places less emphasis on adaptive coping strategies for better emotion-regulation. In contrast, FBT may demonstrate a decrease in depressive symptoms and an increase in self-esteem due to the presence of improved family support. During FBT, family may help patients with emotion-regulation. The aim of this study is to explore the relationship between change in depression and self-esteem measures with CBT and FBT therapy for adolescents with BN. At baseline (BL), 37 adolescents (17 CBT and 20 FBT) with BN between the ages of 12-18 completed the Beck Depression Inventory (BDI) and the Rosenberg self-esteem assessment. Additionally, the BDI and Rosenberg measures were given at session 9 (during treatment), end of treatment (EOT), at a 6 month follow up (6MFU), and at a 12 month follow up (12MFU) for both CBT and FBT treatments. Results reveal that both CBT and FBT significantly improve depressive symptoms and self-esteem, and neither treatment appears to be superior to the other. This is meaningful because families are sometimes concerned that family therapy will not address their child’s depressive symptoms, and here is evidence that it does.

F065: Pre-Treatment Weight Suppression, Eating Pathology, Depressive Symptoms, and Weight Outcomes in a Behavioral Weight Loss Program

Christine Call, BA, Drexel University, Philadelphia, Pennsylvania, Margaret Clark, BS, Drexel University, Philadelphia, Pennsylvania, Alexandra Convertino, BS, Drexel University, Philadelphia, Pennsylvania, Michael Lowe, PhD, Drexel University, Philadelphia, Pennsylvania, Evan Forman, PhD, Drexel University, Drexel, Pennsylvania, Meghan Butryn, PhD, Drexel University, Philadelphia, Pennsylvania

Weight suppression is a robust predictor of symptom severity, treatment outcome, and future weight gain in bulimia and anorexia nervosa. However, research suggests that weight suppression may be unrelated to psychological distress in non-clinical samples of weight-reduced obese or overweight individuals. Little is known about the relation of weight suppression to psychological features and weight outcomes among those in behavioral weight loss (BWL) programs. This study examined relationships among weight suppression, eating pathology, depressive symptoms, and weight outcomes in overweight and obese participants in a 12-month BWL program. At baseline, participants (N=238) reported on: weight history; loss of control/binge eating; dietary restraint, emotional eating, and uncontrolled eating (Three-Factor Eating Questionnaire); expectancies about the negative reinforcement of eating (Eating Expectancy Inventory); psychological sensitivity to the food environment (Power of Food Scale); and depressive symptoms (Beck Depression Inventory). Weight was measured at baseline and end of treatment. Baseline weight suppression was positively associated with dietary restraint, r(195)=0.2, p=.007, but with no other eating or psychological measures. Weight suppression was also correlated with 12-month percent weight losses, such that participants with higher baseline weight suppression lost less weight, r(161)=0.3, p=.002. Participants in the top quartile of weight suppression (weight suppression>17 lbs) versus those in the bottom quartile (weight suppression

F066: Lifestyle Interventions in Bipolar Disorder appear to overlook comorbid Eating Disorders: A Systematic Review

Claire McAulay, BA; Student, MCP/PhD Candidate, University of Sydney, Sydney, NSW, Stephen Touyz, BSc; PhD; FAED, University of Sydney, Sydney, NSW, Jonathan Mond, BA; MPH; PhD; FAED, Western Sydney University, Sydney, NSW, Tim Outhred, BSc; PhD, Academic Department of Psychiatry, Kolling Institute, Sydney, NSW, Gin Malhi, BSc; MD; MBChB FRCPsych FRANZCP, Academic Department of Psychiatry, Kolling Institute, Sydney, NSW

Bipolar disorder is associated with various physical health sequelae, partly due to common pharmacotherapies. High rates of comorbidities with eating disorders also contribute to poor physical health, with around 25% of those with bipolar disorder experiencing binge eating. It has been suggested that this aspect of psychological health is neglected when targeting physical health. This systematic review aimed to explore lifestyle interventions that target weight loss or maintenance in Bipolar Disorder. It aimed to investigate whether psychological factors were routinely measured, and whether comorbidities with eating disorders were screened for or targeted. Finally, it aimed to assess the utilization of evidence-based psychological methods such as CBT to promote physical health gains. PubMed, Medline, SCOPUS and Ovid were systematically searched. Searches were limited to English-language papers and a manual search was also conducted. In total, 242 studies, excluding 52 duplicates, were screened. After reviewing the full text of 35 studies, 25 quantitative studies were assessed for quality. Common study limitations included no control group, highly heterogeneous samples of varying weight and failure to report BMI or waist circumference. Only four of the 25 studies screened and excluded participants with eating disorders. None explicitly targeted eating-disordered cognitions and behaviours, although one did consider binge eating as an outcome measure. Use of psychological techniques was limited to a third of studies, with psychological outcomes assessed in only half. Research into appropriate lifestyle interventions for bipolar disorder is in its infancy, and is generally characterized by a number of methodological issues. Future research should consider exploring psychological pathways to improving diet, exercise, and other health behaviours, by limiting participants to those bipolar disorder, and considering eating-disorder symptoms and targets.

F067: Treating Binge Eating Disorder: To CBT or to DBT?

Mirjam Lammers, MSc, GGNet Amarum, expertise centre for eating disorders; Radboud University, Zutphen / Nijmegen, Outside US, Tatjana van Strien, PhD, Prof., Radboud University; Free University Amsterdam, Nijmegen / Amsterdam

We test whether dialectical behaviour therapy (DBT) is as effective as cognitive behaviour therapy (CBT) for treating binge eating disorder (BED). Therefore we compare DBT to our CBT treatment-as-usual in a randomized controlled trial (RCT). The DBT-protocol is adapted for BED by Safer, Telch & Chen (2009). The CBT-protocol is an extended version of the manual developed by Fairburn, Marcus and Wilson (1993). We assess eating disorder related characteristics, emotion regulation, psychopathology, BMI and overall quality of life both at the start and at the end of treatment. Data-collection is almost complete (N = 60 at present). Findings indicate that both CBT and DBT are effective on all measures. Both treatments are comparably effective on measures related to emotion regulation, psychopathology, BMI and overall quality of life. However, at the end of treatment differences do emerge when looking at binge eating frequency, shape concerns and weight concerns in favour of CBT. All in all we conclude that CBT and DBT are equally effective treatments for BED in many respects. Although CBT seems to do better on eating disorder related measures in the short term, there might be a delayed effect of DBT at follow-up, half a year after treatment. This would be in line with the delayed effect of interpersonal psychotherapy (IPT) when compared to CBT. Indeed, both DBT and IPT do not target disordered eating directly. Collection of follow-up data is still ongoing.

F068: The Effects of Religious Affiliation (Amish, Catholic, Muslim, Non-affiliated) and Religiosity on Women’s Body Image Coping Strategies

Denise Davidson, BS; MS; PhD, Loyola University Chicago, Chicago, Illinois, Elizabeth Hilvert, MA; BA, Loyola University Chicago, Chicago, Illinois, Kelly Hughes, BA; MA, Auburn Unviersity, Auburn, Alabama, Ieva Misiunaite, BA, Loyola University Chicago, Chicago, Illinois

Although there is ample evidence that religiosity is linked to psychological well-being (Gillespie, 2001), research is only beginning to explore the relations between religion and body image. Of the studies conducted, most have found that religion and body image are linked in positive ways (e.g., Dunkel, Davidson, & Qurashi, 2010; Homan & Boyatzis, 2009). The goals of the present research were to explore the relations between religious affiliation, degree of religiosity and body image coping strategies. Also examined were the relations between religiosity and participants’ self-evaluative salience, or the extent to which someone believes looks influence personal worth, and body satisfaction. 356 women participated (18 to 71 years); Catholic (N = 178), Muslim (N = 75), Amish (N = 21) or were not affiliated with a religion (N = 82). Measures included: Body Image Coping Strategies Inventory (Cash, 2003), Appearance Schemas Inventory-Revised (Cash, 2004), Faith Questionnaire (Diduca & Joseph, 2007), Photographic Figure Rating Scale (Swami et al., 2008) and a personal inventory (e.g., age, weight, height, education). Results showed that Amish women engaged in less appearance fixing and more positive rational acceptance body image coping strategies than other women, whereas no differences were found between the other groups. Increased body dissatisfaction (PFRS) and self-evaluative salience (ASI-R) were related to using an avoidance body image coping strategy in all women. For religious women, a lower level of religiosity and a greater degree of body dissatisfaction as well as self-evaluative salience were related to a greater use of an appearance fixing coping strategy. For religious women, a greater degree of religiosity corresponded to a greater use of a positive rational acceptance coping strategy. These results provide evidence that the specific values that are endorsed by a religion, as well as degree of religiosity, may affect how women cope with body image challenges.

F069: A Questionnaire Survey of Support Required by Yogo Teachers to Effectively Manage Students Suspected of Suffering from Eating Disorders

Michiko Nakazato, MD; PhD, Research Center for Child Mental Development, Chiba University, Chiba City, Chiba Prefecture, Kaoru Seike, CPsychol, United Graduate School of Child Development, Osaka University, Chiba City, Chiba Prefecture, Hisashi Hanazawa, MD; PhD, Chiba University, Chiba City, Chiba Prefecture, Toshihiko Ohtani, MD; PhD, Research Center for Child Mental Development, Chiba University, Chiba City, Chiba Prefecture, Shizuo Takamiya, MD; PhD, Nishi Kobe medical Center, Kobe City, Hyogo Prefecture, Ryoichi Sakuta, MD; PhD, Department of Pediatrics, Dokkyo Medical University Koshigaya Hospital, Koshigaya City, Saitama Prefecture

The cooperation of Yogo teachers is essential in helping these students to find appropriate care. To assist Yogo teachers, it is helpful to clarify the encounter rates (the proportion of Yogo teachers who have encountered ED students) and kinds of requested support. As the proportion of teens in the estimated onset ages has increased recently, it has become important to find out and develop support network for ED students early in school and clarify the way of support. Thus, we conducted a wide area survey in Japan for proposing a better framework of support for Yogo teachers in the early support of ED students. A questionnaire survey organized by ED type (based on DSM-5) was administered to Yogo teachers working at elementary/junior high/senior high/special needs schools in four prefectures of Japan in 2015, and 1886 responses were obtained. Based on the results, the encounter rates (the proportions of Yogo teachers who had met ED students) were calculated, and factors that could affect the rates were examined by logistic regression analysis. The order of the encounter rates of the ED type at the four school types was Anorexia Nervosa (AN)>Bulimia Nervosa (BN)>Avoidant/Restrictive Food Intake Disorder (ARFID)>Binge Eating Disorder (BED)>Others. The factors significantly affecting the rates were “location, school type, number of students, experience years, in all the subtypes of the EDs. The predicting factors for encounter the students suffering from AN are having knowledge of symptoms about EDs, school type (high school, junior high school), location (urban area). On the other hand, the predicting factors for finding out students with BN are having knowledge of EDs, location, school type, experience years. The support most required for all ED types was "a list of medical/consultation institutions”. A factor affecting the encounter rate of all ED types was the ED knowledge. In addition, senior high schools were the type of school with the highest encounter rates for AN, BN and BED, and special needs schools had the highest rates for Others. These findings imply that in order to find out and support students having the potential of suffering from EDs. Construction for development of support network system is required as well as providing knowledge of the corresponding ED symptoms and management at school in the community.

F070: Can't See the Forest for the Trees? Refining Our Understanding of Weak Central Coherence in Adolescent Anorexia Nervosa

Noam Weinbach, PhD, Stanford University, Palo Alto, California, Amit Perry, PhD, Ben-Gurion University of the Negev, Beer-Sheva, Israel, Helene Sher, MD, Soroka Medical Center, Beer-Sheva, Israel, Avishai Henik, PhD, Ben-Gurion University of the Negev, Beer-Sheva, Isarel, James Lock, MD; PhD, Stanford University, Palo Alto, California

Over-processing of details (local processing bias) at the expense of processing the bigger picture (global processing) is a phenomena known as “weak central coherence” (WCC). Multiple studies in recent years showed that WCC is a central feature in patients with anorexia nervosa. Some suggested that WCC is a cognitive marker for the disorder with genetic origins (i.e., an endophenotype). However, there are several important questions yet to be answered: is WCC in anorexia nervosa present at adolescence? What are the underlying mechanisms of WCC in anorexia nervosa? Can WCC be remediated? The goal of the present study was to answer these questions. 19 weight-restored adolescents with anorexia nervosa and 22 healthy adolescents performed the global/local processing task (Navon Task). Alerting cues that are known for enhancing global processing were integrated into the task. The results demonstrated that the central feature of WCC in anorexia nervosa is greater interference from details (local interference) when attending to the bigger picture. Furthermore, greater local interference was associated with greater illness severity and poor body-image. Alerting cues reduced patients’ local interference to a comparable level with controls, illustrating that WCC is a modifiable process. Findings of this study support the view that WCC may be an endophenotype for anorexia nervosa that is also correlated with clinical severity.

F071: Family Cognitive Remediation Therapy for Adolescents with Anorexia Nervosa: A Case Report

Rie Kuge, MD; Student, Tokyo Metropolitan Children's Medical Center, Fuchu-shi, Tokyo, Ayano Yokota, CPsychol, Tokyo Metropolitan Matsuzawa Hospital, Setagaya-ku, Tokyo, Noriko Numata, Ns, Chiba University, Chiba-shi, Chiba, Michiko Nakazato, MD; PhD, Chiba University, Chiba-shi, Chiba

Cognitive remediation therapy (CRT) aims to increase patients’ cognitive flexibility by practicing new ways of thinking as well as facilitating bigger picture thinking, supporting patients with relevant tasks, and making them aware of their own thinking styles. CRT has since been applied in the treatment of anorexia nervosa (AN), and it has proven to be effective, acceptable, and beneficial. In adolescents, CRT has been piloted in both individual and group format observational studies. Family therapy is also proven to be an effective treatment for 70-80% of adolescents with AN. However, there are limited number of studies integrating CRT and family therapy for adolescents with AN. The objective of this case report is to illustrate how family CRT can be feasible and acceptable for adolescents with AN. A 15-year-old patient had been suffering from AN for 2 years. She suffered from intense anxiety and low self-esteem. In the first session, which was conducted with her alone, it was difficult for her to think about her own thinking styles, but she did homework with her mother and found reflection to be easier when her mother advised her. Her mother was invited to the next session and her father occasionally participated in the sessions. During the sessions with her parents, she became relaxed as her parents helped her to reflect, provided positive feedback, and could encourage her to apply the strategies to daily life. She along with her parents completed 10 sessions. Family CRT could also improve communication among family members. Family CRT for adolescents with AN was well received. Further research will be required to evaluate the effectiveness of family CRT.

F072: Improving the Transition of Care from a Specialty Eating Disorders Program to the Primary Care Provider

Cathleen Steinegger, MSc; MD, The Hospital for Sick Children, Toronto, Ontario, Jaimie Kenneday, RD, The Hospital for Sick Children, Toronto, Ontario, Seena Grewal, MD; MSc, The Hospital for Sick Children, Toronto, Ontario, Alene Toulany, MSc; MD, The Hospital for Sick Children, Toronto, Ontario, Khush Amaria, PhD, The Hospital for Sick Children, Toronto, Ontario, Jessica Watts, APRN-BC; MSc, The Hospital for Sick Children, Toronto, Ontario, Tania Turrini, RD, The Hospital for Sick Children, Toronto, Ontario, Jill O'Brien, RD, The Hospital for Sick Children, Toronto, Ontario

Approximately half of adolescents with eating disorders recover while 50% continue to be affected by the illness into their young adult years. Even those who recover may have ongoing medical issues related to their eating disorder, such as loss of bone density, that require follow up. The transition of adolescent patients with eating disorders from the specialized pediatric Eating Disorders Program at The Hospital for Sick Children (SickKids), a tertiary care pediatric hospital, to adult care services occurs at age 18 years. The process of connecting youth to a different health care system is often poorly coordinated and carries potential patient safety risks, such as health care drop-out, poor treatment adherence, and worse overall health outcomes in adulthood. Previous Quality Improvement (QI) work has shown that the majority of transition age youth in our program return to their primary care provider (PCP) for follow up and ongoing medical care. Historically, SickKids has not used a shared care model involving PCPs while a patient is receiving treatment in our program. This may occur for many reasons including the need for specialized medical care by adolescent medicine physicians, family preference, and lack of familiarity with eating disorder treatment by the PCP. This QI project explores the experience of PCPs receiving patients who are ageing out of the SickKids Eating Disorders Program who may or may not also be transitioning to specialized adult eating disorder services. Through interviews with PCPs, we seek to understand their perceived barriers (and enablers) to providing care to these patients and their comfort with recognizing medical complications of eating disorders. The results will inform the development of a set of tools and procedures to improve engagement of PCPs in shared care throughout the course of their patient’s eating disorder treatment at SickKids and during the transition period leading up to and after their patient’s 18th birthday.

F073: Avoidant/Restrictive Food Intake Disorder: Categorization of Subtypes and Longitudinal Outcomes after Day Hospitalization

Amanda Bryson, BS, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, Anna Scipioni, BS, Penn State Health Children's Hospital, Hershey, Pennsylvania, Rollyn Ornstein, MD, Penn State Health Children's Hospital, Hershey, Pennsylvania

The purpose of this study was to describe subtypes of patients with ARFID, and examine their course and outcome through day treatment and follow-up. An in-depth retrospective chart review was performed on a group of 20 patients with ARFID. Follow-up data, including interviews, anthropometrics, and Children’s Eating Attitudes Test (ChEAT) scores, were available as part of a larger prospective cohort study of patients admitted to an ED day hospital, at least 12 months after discharge. Patients were grouped into three subtypes: 5 patients with anxiety and/or gastrointestinal symptoms (Subtype 1); 7 patients with inadequate/restricted food intake (Subtype 2); and 8 patients with fear of choking or vomiting (Subtype 3). The study sample was 70% female, with a mean age of 11.4 ± 1.6 years at admission to the day hospital. Duration of day hospitalization was 6.8 ± 3.6 weeks. The average time between discharge and study follow-up was 31.1 ± 14.7 months. %MBW was higher at discharge than at admission (88.1 vs. 81.4%; p=0.0002) and at follow-up than at discharge (95.1 vs. 88.1%; p=0.008). ChEAT score was lower at discharge than at admission (p=0.049), but was not significantly different at follow up than at discharge. At follow-up, 75% described themselves as mostly or fully recovered, and all subtypes achieved ≥90% %MBW and had subclinical ChEAT scores. Subtype 1 had the lowest %MBW at admission (78.1 ± 16.7%) and the highest ChEAT score (27.2 ± 21.7). Subtype 3 had the highest rate of self-reported recovery (87.5%) compared to Subtypes 1 (60%) and 2 (57.1%), while Subtype 2 had the lowest percentage of patients reporting current ED symptoms (28.6%), compared to Subtypes 1 (80%) and 3 (62.5%). Subtypes 1 and 3 each had one recorded relapse, while Subtype 2 had none. This study describes 3 subtypes of ARFID, with favorable outcomes achieved through participation in day treatment, and at longer-term follow up, based on weight and ChEAT scores. The persistence of subclinical ChEAT scores over time may indicate that patients with ARFID do not subsequently develop another ED, such as anorexia nervosa. Additionally, these results suggest there may be a difference in the outcomes of ARFID patients based on the predominant presenting symptom.

F074: Prevalence and Correlates of Childhood Obsessive-Compulsive Traits in Eating Disorders

Paolo Meneguzzo, MD, Department of Neuroscience, University of Padova, Padova, Italy, Daniela Degortes, PhD, PsyD, Department of Neuroscience, University of Padova, Padova, Italy, Tatiana Zanetti, PsyD, Department of Neuroscience, University of Padova, Padova, Italy, Elena Tenconi, PhD, PsyD, Department of Neuroscience, University of Padova, Padova, Italy, Elisa Bonello, PsyD, Padova, Italy, Manuela Soave, PsyD, Department of Neuroscience, University of Padova, Padova, Italy, Paolo Busetto, MD, Department of Neuroscience, University of Padova, Padova, Italy, Paolo Santonastaso, MD, Department of Neuroscience, University of Padova, Padova, Italy, Angela Favaro, MD, Department of Neuroscience, University of Padova, Padova, Italy

Few studies to date have investigated the prevalence and clinical and neuropsychological correlates of obsessive-compulsive personality traits, in particular perfectionism, in patients with eating disorders (ED). The aims of the present study were twofold: 1) to retrospectively examine the prevalence of childhood obsessive-compulsive personality traits in adult patients with ED and in healthy controls (HC) and 2) to explore the quantitative relationship between these premorbid traits and several clinical and neuropsychological variables. 203 ED patients -130 with pure Anorexia Nervosa (AN), 25 with pure Bulimia Nervosa (BN), and 48 with BN with a prior history of AN (AN+BN)- and 144 healthy women were assessed by the self-reported Childhood Retrospective Perfectionism Questionnaire (CHIRP) to examine childhood traits such as perfectionism, inflexibility and drive for order and symmetry. Several other standardized instruments were used to assess the clinical and neuropsychological profile. Participants with an ED reported a significantly higher prevalence of Perfectionism, Inflexibility and Symmetry in childhood compared to controls. In particular, the AN+BN group reported the highest rate of obsessive-compulsive personality traits. No significant difference was found between pure BN and HC. In patients with ED, a dose-response relationship was found between the number of childhood obsessive-compulsive personality traits and the risk of having an ED, and between the number of childhood obsessive-compulsive personality traits and psychopathology, including neuropsychological difficulties such as set shifting and weak central coherence. These findings suggest the need of early identification and treatment of childhood perfectionism as well as other obsessive-compulsive traits, for prevention or improvement of ED outcome.

F075: Investigating the Influence of Shame, Depression, and Distress Tolerance on the Relationship between Internalized Homophobia and Binge Eating in Lesbian and Bisexual Women

Vanessa Bayer, PhD, Eating Recover Center of Houston, Houston, Texas, Danielle Gonzales, PsyD, University of California, San Diego, San Diego, California

There is limited research evidence about the specific factors influencing disordered eating for lesbian and bisexual women. Therefore, this study investigated relationships among binge eating, internalized homophobia, shame, depression, and distress tolerance in a sample of lesbian (n = 72) and bisexual women (n = 66). Two hypotheses were tested. First, it was hypothesized that shame and depression would mediate the relationship between internalized homophobia and binge eating. Second, it was hypothesized that distress tolerance would moderate the relationship between shame and binge eating and the relationship between depression and binge eating in the mediation relationships proposed in the first hypothesis. Results indicated that shame was a significant mediator for the relationship between internalized homophobia and binge eating, that depression was not a significant mediator, and that distress tolerance did not moderate the significant mediation relationship between shame and binge eating. The data in this study also indicated that the proportions of lesbian and bisexual participants who reported binge eating and compensatory behavior did not differ significantly, but that bisexual participants reported significantly more depression and shame than lesbian participants.

F076: Problematic Eating behaviours and Social Cognition in Preadolescence - An epidemiological study of risk factors in the Copenhagen Child Cohort 2000

Stephanie Stensbjerg Christensen, Student, Medical student, University of Copenhagen,medical student, Copenhagen, Capital Region, Else Marie Olsen, MD; PhD; FAED, Child and Adol Psychiatrist, University of Copenhagen, Department of Public health, Section for social medicine, Copenhagen, Capital Region, Lars Clemmensen, MS; PhD, Child and Adolescent Mental Health Centre, Copenhagen, Capital Region, Mette Bentz, MS; PhD-student, Child and Adolescent Mental Health Centre, Copenhagen, Capital Region, Anja Munkholm, MD; PhD-student, Department of Paediatrics, Hillerød, Capital Region, Anne Mette Skovgaard, MD; D.Sci.; Child and Adol. Psychiatrist, Department of Public health, Section for social medicine, University of Copenhagen

It has been hypothesized that deficiencies in social cognition might influence the onset or maintenance of eating disorders. Deficits in two subdomains of social cognition are well documented in eating disorder patients: emotion perception and Theory of Mind (ToM). However, the causal direction is unclear, and the association between impaired social cognition and problematic eating prior to the development of any eating disorder has only been sparsely studied. The aim of the present study is to investigate possible associations between problematic eating and social cognition in a general population of preadolescents. The study is part of the Copenhagen Child Cohort 2000 (CCC2000) following 6090 children prospectively from birth. The cohort has been assessed in infancy (0-1y), preschool-age (5-7y), and preadolescence (11-12y), including measures of problematic eating and mental difficulties. At 11-12 years 1630 children attended a test of ToM (the Storybook Frederik), while problematic eating was measured using the Eating Pattern Inventory for Children. Mental disorders were assessed using the Development and Well-Being Assessment (DAWBA). Also, register data of hospital diagnosed eating or autism-spectrum disorders from 0-12 years of age are available. Analyses will be carried out during the winter/spring 2017 including logistic regression adjusting for possible confounders and mediators (gender, onset of puberty, mental disorders, cognitive function, socio-economic status, and weight). The results will be ready for presentation at the congress. We expect to find cross-sectional associations between problematic eating and poor ToM in preadolescence, especially concerning restrictive eating patterns. Associations are expected to be only partly explained by weight-status, cognitive function, and comorbidity. With a significance level of 5% and power of 80% the study will be able to detect an association between impaired ToM and problematic eating with an OR of 2.

F077: How does the Desire to Lose Weight Affect Engagement in an Online Eating Disorder Intervention?

Neha Goel, BA, Stanford University School of Medicine & Palo Alto University, Stanford & Palo Alto, California, Rachael Flatt, BS, Stanford University, School of Medicine & Palo Alto University, Stanford & Palo Alto, California, Shiri Sadeh-Sharvit, PhD, Stanford University, School of Medicine, Stanford, California, Ellen Fitzsimmons-Craft, PhD, Washington University in St. Louis, School of Medicine, St. Louis, Missouri, Katherine Balantekin, PhD; RD, Washington University in St. Louis, School of Medicine, St. Louis, Missouri, Grace Monterubio, BA, Washington University in St. Louis, School of Medicine, St. Louis, Missouri, Mickey Trockel, MD; PhD, Stanford University, School of Medicine, Stanford, California, Denise Wilfley, PhD, Washington University in St. Louis, School of Medicine, St. Louis, Missouri, C. Barr Taylor, MD, Stanford University, School of Medicine & Palo Alto University, Stanford & Palo Alto, California

Patients in eating disorders (EDs) treatment often express a desire to work on other health outcomes, such as losing weight. Regardless of whether an intervention addresses weight loss, it is important to understand how this desire can affect a patient’s engagement with treatment. Understanding patients’ weight loss goals (WLG) could inform development and refinement of interventions that would acknowledge these concerns, increase adherence, and improve treatment satisfaction. This study evaluated how weight gain prior to enrollment and WLG influenced participants’ engagement in treatment. Participants were 144 female college students from 13 campuses across the United States who screened positive for an ED participating in the Healthy Body Image program (HBI), an online, CBT-based, guided self-help program that does not specifically address weight loss. Participants’ average age was 22.0 years and 61.3% were Caucasian, 24% Asian, and 6% African American. Content analysis of users’ stated goals at baseline assessed subjective motivation for enrollment; 31% explicitly self-endorsed WLG. Users that endorsed WLG completed an average of 17.3 out of 63 total sessions and gained an average of 14.0 lbs in the year prior to entering the program compared to their non-WLG counterparts who completed an average of 18.0 sessions and gained 11.7 lbs. Using a one-way ANOVA, no significant differences in number of completed sessions or weight gain were observed between users who endorsed WLG and those who did not. Findings suggest that WLG are independent of recent weight gain, and regardless of the presence of WLG, female college students can remain engaged in an online ED intervention. Though weight gain and WLG could be motivating factors for female college students when initially enrolling in an ED program, they remain engaged for additional reasons. As such, participants with an ED who want to lose weight can still engage in a program that does not focus on weight loss.

F078: Effect of Parental Criticism on Disordered Eating Behaviors in University Students from Mexico City

Concepcion DiazdeLeon-Vazquez, MSc, Metropolitan Autonomous University., Mexico City, Mexico, Claudia Unikel-Santoncini, PhD, National Institute of Psychiatry "Ramon de la Fuente Muñiz", Mexico City, Mexico City, Aremis Villalobos-Hernandez, PhD, National Institute of Public Health, Mexico City, Mexico City, Jose Alberto Rivera-Marquez, PhD, Metropolitan Autonomous University., Mexico City, Mexico City

The objective of this work was to analyze the effect of parental criticism on the risk of disordered eating behaviors (RDEB) in university students from Mexico City. A sample of 892 first year students from a public university (502 female, with an average age of 19.3 ± 2.5 years; and 390 male with an average age of 20.4 ± 3.3 years) was included in the study. Sociodemographic variables (sex, age, socioeconomic status), body dissatisfaction, self-esteem, depressive symptoms and body mass index were explored. Ordinal regression models were used to analyze the association of RDEB and criticism from parents. In female students RDEB increased as a result of criticism from both parents (OR=2.5), criticism from their mothers only (OR=2.0), overweight (OR=1.7), obesity (OR=2.1), drive for thinness (OR=8.3) and depressive symptoms (OR=3.3). Whereas in men, RDEB increased as a result of criticism from both parents (OR=2.7), obesity (OR=2.4), drive for thinness (OR=3.4) and depressive symptoms (OR=2.8). All associations were statistically significant (p < 0.05). Criticism from parents is important to understand disordered eating behaviors in university students. Where possible, the family should be included in planning and carrying out disordered eating behaviors prevention among this population group.

F079: Childhood Maltreatment among Treatment-Seeking Patients with Binge-Eating Disorder: Prevalence and Associations with Eating Disorder Psychopathology, Functional Variables and Treatment Outcome

Michaela Nagl, DiplPsych, University of Leipzig, Department of Psychosomatic Medicine and Psychotherapy, Leipzig, Sachsen, Birgit Wagner, PhD, Medical School Berlin, Berlin, Berlin, Ruth Doelemeyer, DiplPsych, University of Leipzig, Department of Psychosomatic Medicine and Psychotherapy, Leipzig, Sachsen, Grit Klinitzke, PhD, University of Leipzig, Department of Psychosomatic Medicine and Psychotherapy, Leipzig, Sachsen, Jana Steinig, PhD, University of Leipzig, Department of Psychosomatic Medicine and Psychotherapy, Leipzig, Sachsen, Jana Steinig, PhD, University of Leipzig, Department of Psychosomatic Medicine and Psychotherapy, Leipzig, Sachsen

The study aimed to examine the prevalence of different types of childhood maltreatment among patients with binge-eating disorder (BED) seeking treatment within a randomized-controlled trial (RCT) of a 16-week Internet-based cognitive behavioral therapy for BED. Additionally, we explored associations of histories of childhood maltreatment with eating disorder psychopathology, functional variables and treatment outcome. The RCT sample consisted of 139 patients with BED (DSM-IV) aged between 18 and 61 years. Of those, 69 were randomized to the intervention group (IG) and 70 to a wait-list condition. Assessment times were before and directly after the intervention and 3, 6, and 12 months follow-up. Histories of physical, emotional, and sexual abuse as well as physical and emotional neglect were retrospectively assessed with the Childhood Trauma Questionnaire. The following measures were used as outcome assessments: Eating Disorder Examination Questionnaire, Beck Depression Inventory, General Self-Efficacy Scale, Satisfaction with Life Scale, Body Mass Index (BMI). 89.1% reported a history of any childhood maltreatment. Physical, emotional, and sexual abuse were reported by 27.5%, 67.4% and 31.2%.The prevalence of physical and emotional neglect was 42.0% and 74.6%. At baseline, childhood maltreatment was not associated with eating disorder psychopathology or depressive symptoms (Bonferroni correction). Emotional abuse, and emotional and physical neglect were associated with lower self-efficacy and lower satisfaction with life (-0.32≤r≤-0.24; p-values < 0.005). Physical abuse was associated with a higher BMI (r= 0.26, p=0.002). In the IG, treatment dropout was predicted by all types of childhood maltreatment, except for sexual abuse. At posttreatment, a history of emotional neglect was associated with a higher level of weight concerns (r=0.42, p=0.002) in the IG among those who completed the intervention. Furthermore, emotional and physical neglect were associated with lower satisfaction with life after the intervention. At follow-up assessments, no associations between a history of any childhood maltreatment and treatment outcome variables were found (completer analysis, Bonferroni correction).

F080: Exploring Attitudes Towards Bariatric Surgery Patients and Policies in Canada

Lauren David, BA; MA, Ryerson University, Toronto, Ontario, Paula Brochu, PhD, Nova Southeastern University, Fort Lauderdale, Florida, Stephanie Cassin, PhD, Ryerson University, Toronto, Ontario

Explicit and implicit stigma toward individuals with obesity are widespread. A burgeoning new literature also indicates that “residual” weight stigma exists for individuals who had previously been, but are no longer, obese. These negative attitudes are affected by weight loss method, such that stigma is strongest for people who lose weight through bariatric surgery as compared with diet and exercise. Stigma associated with obesity has been found to be a key contributing factor to poor quality of life, and thus it is important to develop a better understanding of the factors contributing to the development and maintenance of negative attitudes towards bariatric surgery and their malleability. The purpose of the current study was to examine the impact of visual portrayals of obesity on support for Canadian policies that facilitate patient access to bariatric surgery and on attitudes towards individuals who undergo the procedure. A total of 275 Canadian participants (N = 175 for the original study, and N = 100 for a replication) were recruited using Crowdflower, a crowd-sourcing platform for online recruitment and data collection. Participants read a news story about a policy to facilitate obese individuals’ access to bariatric surgery and were randomly assigned to view the article accompanied by a nonstigmatizing image, stigmatizing image, or no image of an obese individual. Contrary to our hypotheses, the groups generally did not differ in their support of the policies depicted in the article. In the original study, the no image condition reported the least stigmatizing attitudes towards patients (p < 0.18); however, this finding was not replicated in the subsequent study. Although the results suggest that visual portrayals do not significantly influence attitudes towards bariatric surgery, it was found that more favourable views towards the procedure were significantly associated with participant Body Mass Index (r = .31, p < .001), knowing someone who is considering or has had bariatric surgery (t = 3.61, p < .001), and greater perception of knowledge about the procedure (r = .24, p = .001). This line of research continues to be imperative in order to inform strategies for reducing stigma, thereby improving access to bariatric care for those who can benefit from it and quality of life for those who have had the procedure.

F081: Psychological distress in obese women at risk for eating disorder from Buenos Aires, Argentina.

Jesica Custodio, CPsychol, Facultad de Psicología. Universidad de Buenos Aires., Buenos Aires, Argentina, Brenda Murawski, CPsychol; PhD, Facultad de Psicología, Universidad de Buenos Aires., Buenos Aires, Argentina, Luciana Elizathe, CPsychol; PhD, Facultad de Psicología, Universidad de Buenos Aires., Buenos Aires, Argentina, Guillermina Rutsztein, CPsychol; PhD, Facultad de Psicología, Universidad de Buenos Aires, Buenos Aires, Argentina

One of the most common complications in obesity treatment is that it usually co-exists with eating disorders (ED) and intense psychological distress. The aim of the study was to compare psychological distress in obese patients at risk and non-risk for eating disorder. The opportunity sample included 65 obese women (according to World Health Organization criteria) aged 18 to 65 from Buenos Aires. Patients were in the initial stage of treatment. They voluntarily completed the three subscales of risk of Eating Disorder Inventory-3 (EDI-3) and the Symptoms Checklist-90-Revised (SCL-90). The Global Severity Index of the SCL-90 (GSI) is a good indicator of severity distress because it combines current symptoms with intensity of perceived distress. Two groups were formed: patients at risk for eating disorder (RED group) and patients at non-risk for eating disorder (NRED group). In the RED group, the average age was 38.06 years (S.D. = 9.70) and a BMI of 34.76 kg/m2 (S.D. = 3.03). In the NRED group, the average age was 44.69 years (S.D. = 9.93) and a BMI of 34.02 kg/m2 (S.D. = 2.99). The 50.8% of the sample was at risk for eating disorder (RED group) while the 49.2% did not present risk (NRED group). Mann-Whitney test was applied to compare groups regarding the GSI. Significant differences were found (U = 214.500, Z = - 4.11, p < 0.001). The RED group presented a GSI significantly greater (Mdn = 1.24) concerning the NRED group (Mdn = 0.48). The high percentage of risk of eating disorder in this obese sample is striking. Also, high levels of psychological distress in obese patients that present RED indicate the need of preventive approaches aimed to avoid not only the development of ED but also symptoms of psychopathology that could interfere in treatment.

F082: Self-Compassion in the Face of a Body Image Threat is Contagious Across Individuals

Kathryn Miller, BSc; MA, University of Waterloo, Waterloo, Ontario, Allison Kelly, BA; PhD, University of Waterloo, Waterloo, Ontario, Iulia Banica, BSc, University of Waterloo, Waterloo, Ontario

Research shows that hearing others engage in ‘fat talk,’ which involves making self-disparaging comments about one’s appearance, can lead to higher levels of body dissatisfaction in the listener. However, there is little research investigating the impact of more positive forms of body talk on listeners. Self-compassion is the ability to be accepting and kind to oneself in the face of personal distress and has been shown to protect against the effects of negative body image. The current study examines whether hearing someone else’s self-compassionate reaction to a situation that threatened their body image can attenuate the negative impact of considering a personal body image threat. Ninety-five female university students listened to a self-compassionate, self-esteem enhancing, or objective reaction to a body image threat and then completed various visual analog measures of affect and self-compassion while recalling a personal body image threat. Factor analysis of the visual analog items revealed a positive affect factor comprised of feeling reassured, happy, proud, energized, self-compassionate, and caring towards oneself. ANOVAs revealed a Condition X time effect such that hearing a self-compassionate reaction caused significantly greater improvements in positive affect when recalling a personal body image threat than hearing a self-esteem enhancing or factual reaction. These findings add to the literature establishing self-compassion as a buffer against body-image threats and extend these findings by suggesting that displays of body-focused self-compassion can be transmitted across individuals. Clinical implications include the potential benefits of having self-compassion modelled by one’s peers, and suggest that group therapies for eating disorders find ways to capitalize on this process. Practically, they also suggest that interacting with self-compassionate others could mitigate the negative impact of day-to-day social interactions that threaten young women’s body image.

F083: A Comparative Content Analysis of Thinspiration vs. Fitspiration Messaging

Melissa Kwitowski, MS, Virginia Commonwealth University, Richmond, Virginia, Courtney Simpson, MS, Virginia Commonwealth University, Richmond, Virginia, Suzanne Mazzeo, PhD, Virginia Commonwealth University, Richmond, Virginia

Fitspiration refers to online content nominally intended to promote health and fitness. Fitspiration messages are often viewed as the “healthier” alternative to thinspiration, or content that actively advocates weight loss and disordered eating behaviors. Yet, some research suggests that fitspiration messaging might not be fully distinct from thinspiration. This study analyzed body image standards communicated in thinspiration and fitspiration content. Fitspiration (n = 1050) and thinspiration (n = 1050) messaging on the photo-sharing social media platform Pinterest were evaluated using content analytic strategies. Two independent raters coded the images and text present in the posts. Body image messages were categorized as appearance-related or health-related. Chi square analyses compared type of content (thinspiration or fitspiration) and standards promoted (appearance-related or health-related). Results revealed a statistically significant association between content type and body image standard promoted. Thinspiration pins were more likely to promote appearance-based body image standards. Yet, both the majority of thinspiration pins (83.8%) and majority of fitspiration pins (71.7%) promoted appearance-related standards rather than health-related standards. Thinspiration pins were also more likely than fitspiration pins to praise model thinness and portray a pose emphasizing thinness (all ps < .05). Conversely, fitspiration pins were more likely than thinspiration pins to praise model fitness and depict a pose emphasizing fitness (all ps < .05). Findings suggest that although thinspiration pins more frequently promote appearance-related body image standards, the majority of both fitspiration and thinspiration content espouse the importance of appearance as related to body image. Thus, fitspiration images might be harmful to those at risk for eating disorders and related conditions.

F084: Objectified Body Consciousness, Appearance Schemas, and Body Image in Religious (Catholic, Muslim) and Non-religious Women

Denise Davidson, BS; MS; PhD, Loyola University Chicago, Chicago, Illinois, Kelly Hughes, BA; MA Auburn University, Auburn, Alabama, Elizabeth Hilvert, BA; MA, Loyola University Chicago, Chicago, Illinois, Ieva Misiunaite, BA, Loyola University Chicago, Chicago, Illinois, Chelsea Hoy, Student, Loyola University Chicago, Chicago, Illinois

A number of studies have explored the profound negative consequences of a culture’s objectification of a women’s body on her body image. The main purpose of the present research was to explore how a specific religious affiliation (Catholic, Muslim, No Religious Affiliation), and degree of religiosity, affected body surveillance, body shame and control beliefs on the Objectified Body Consciousness Scale (OBC; Mckinley & Hyde, 1996). Previous research has shown that religiosity can be associated with better body image (e.g., Dunkel, Davidson, & Qurashi, 2010; Homan & Boyatzis, 2009), although the mechanisms for this effect are not well understood. 334 women (18 - 71 years) participated: Catholic (N = 178), Muslim (N = 75), or Nonreligious (N = 81). Measures included the OBC, which is comprised of three subscales: body surveillance, body shame, and control beliefs, the Appearance Schemas Inventory-Revised (Cash, 2004), the Photographic Figure Rating Scale (Swami et al., 2008), and a personal inventory (e.g., age, height, weight, education, etc). Results showed that religious women (Catholic, Muslim) scored lower on body surveillance than non-religious women. No differences were found between all groups on endorsement of body shame or control beliefs. For both religious and non-religious women, a higher level of body shame was related to a lower level of religiosity and a greater degree of body dissatisfaction and self-evaluative salience. For Muslim women, style of dress (Western or Non-Western) affected their responses on the OBC. Muslim women who reported greater frequency of wearing Non-Western dress endorsed fewer body surveillance items than Muslim women wearing Western dress. In all women, increased body surveillance was related to an increase in self-evaluative salience, or the belief that their appearance influences their worth. These results suggest that the role of religion on body image, particularly vis-à-vis the objectification processes, is complex.

F085: “Not Just Right" Experiences Account for Unique Variance in Eating Pathology

Grace Kennedy, BA, Florida State University, Tallahassee, Florida, Katherine McDermott, BA, Florida State University, Tallahassee, Florida, Brittany Mathes, BA, Florida Sate University, Tallahassee, Florida, Berta Summers, MS, Florida State University, Tallahassee, Florida, Jesse Cougle, PhD, Florida State University, Tallahassee, Florida

Previous research suggests that not just right experiences (NJREs), or uncomfortable sensations of incompleteness resulting from the mismatch between one’s desired state/environment and actual state/environment, may be associated with eating pathology. The current study sought to examine the association between NJREs with disordered eating behaviors and attitudes in a sample of unselected undergraduate students. Participants (n=248) completed the Eating Disorder Inventory Bulimia and Drive for Thinness subscales, the NJRE Questionnaire Revised, and two in vivo measures of NJREs. In separate linear regression models controlling for obsessive-compulsive symptoms and negative affect, self-report NJRE frequency (β = 0.22, p=0.02, R2 change = 0.04) and NJRE severity (β = 0.16, p=0.03, R2 change = 0.02) accounted for unique variance in drive for thinness. Similar associations were found between NJRE frequency (β = 0.14, p=0.049, R2 change = 0.01) and NJRE severity (β = 0.25, p<0.001, R2 change = 0.04) with bulimic symptoms. Further, discomfort elicited by the in vivo visual NJRE task (β = 0.31, p<0.001, R2 change = 0.07) was uniquely related to drive for thinness, but not bulimic symptoms. Auditory NJRE response was unrelated to symptoms of bulimia and drive for thinness. The present study provides initial evidence for the association between eating disorders and NJREs, a unique construct not previously examined in relation to eating disorder symptoms. This represents a promising first step in exploring how these experiences may contribute to the development and maintenance of eating disorders.

F086: On the (Mis)Measurement of Thin-Ideal Internalization: Implications for Interpretation of Risk Factors and Treatment Outcome in Eating Disorders Research

J. Kevin Thompson, PhD, University of South Florida, Tampa, Florida, Lauren Schaefer, MA, University of South Florida, Tampa, Florida

Internalization of the thin ideal is a theorized risk factor for disordered eating and a meaningful target of prevention and intervention work. Although two primary measures – the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ) and Ideal Body Stereotype Scale (IBSS) – are used interchangeably to assess internalization, limited work has examined the assumption that the two measures index the same underlying construct. The SATAQ-4R-Internalization: Thin/Low Body Fat subscale, IBSS-Revised, and Eating Disorder Examination Questionnaire were administered to 1,114 college females. Exploratory factor analysis indicated that the SATAQ-4R and IBSS-R assess separate constructs, reflecting internalization or personal acceptance of the thin ideal and awareness of the thin ideal, respectively. Social psychological theories suggest that internalization of social norms engender more psychological distress than awareness. Consistent with theory, internalization assessed via the SATAQ-4R was more strongly related to disordered eating (r = .54, large correlation) than awareness assessed via the IBSS-R (r = .45, medium correlation). Moreover, hierarchical multiple regression analyses indicated that the SATAQ-4R (β = .44) was a stronger predictor of disordered eating than the IBSS-R (β = .21). Results suggest that the two most commonly used measures of thin ideal internalization may actually capture two distinct constructs representing different levels of engagement with the thin ideal. Moreover, internalization may be a more potent risk factor for disordered eating than awareness. Extant literature utilizing the SATAQ and IBSS must be interpreted in light the current findings. Future work examining thin ideal internalization or awareness as a risk factor or treatment target should seek to utilize measures that most accurately reflect the intended construct.

F087: Comparing Eating Disorder Psychopathology, Clinical Impairment, and Comorbid Symptoms in Minority and Non-Minority College Women with Eating Disorders

Grace Monterubio, BA; Student, Washington University in St. Louis, St. Louis, Missouri, Ellen Fitzsimmons-Craft, PhD, Washington University School of Medicine, St. Louis, Missouri, Katherine Balantekin, PhD; RD, Washington University School of Medicine, St. Louis, Missouri, Shiri Sadeh-Sharvit, PhD, Stanford University, School of Medicine, Stanford, California, Neha Goel, BA, Stanford University, School of Medicine & Palo Alto University, Palo Alto, California, Marie-Laure Firebaugh, MSW, Washington University School of Medicine, St. Louis, Missouri, Rachael Flatt, BS, Stanford University, School of Medicine & Palo Alto University, Palo Alto, California, Mickey Trockel, MD; PhD, Stanford University, School of Medicine, Stanford, California, C. Barr Taylor, MD, Stanford University, School of Medicine & Palo Alto University, Palo Alto, California, Denise Wilfley, PhD, Washington University School of Medicine, St. Louis, Missouri

Though eating disorders (EDs) affect individuals across all racial and ethnic groups, more information is needed regarding the similarities and differences in ED presentation between minority and non-minority individuals. Participants were 686 college women across 27 universities in the US who screened positive for an ED, with the exception of anorexia nervosa. Levels of ED psychopathology (i.e., EDE-Q Global and subscales), ED behaviors (i.e., binge eating, vomiting, laxatives, exercise), ED-related clinical impairment, and comorbid psychopathology (i.e., depression, anxiety, sleep problems) were compared between the minority and non-minority students. Participants were classified as non-minority (n=359) if they identified themselves as Caucasian and non-Hispanic, and minority (n=327) if they identified themselves as African American, Asian, Native Hawaiian or Pacific Islander, American Indian or Alaska Native, more than one race, and/or Hispanic. Significant differences were found between the groups only in frequency of binges (p = .004) and sleep problems (p = .045), such that minority students reported more frequent binge eating and greater sleep problems. No other significant differences emerged between the groups (ps > .176). These findings suggest that minority and non-minority college women with EDs display comparable levels of ED psychopathology, behaviors, clinical impairment, and comorbid psychopathology, with the exceptions of binge eating and sleep problems being elevated in minority women compared to their non-minority counterparts. The comparable severity of psychopathology across groups demonstrates the importance of increasing access to care for this population who has historically been less likely than their non-minority counterparts to receive care or even be screened for ED symptoms. Future research should also work to develop tailored interventions that address the particular needs of this population.

F088: A Survey on Attitudes Toward Treatment Refusal for Eating Disorders in Members of the Psychiatric Review Board

Yoshiyuki Takimoto, PhD, Department of Biomedical Ethics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan, Yukari Yamamoto, MA, Department of Biomedical Ethics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan, Shiho Urakawa, MD, Department of Biomedical Ethics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan, Akira Akabayashi, MD, PhD Department of Biomedical Ethics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

Background: Individuals suffering from an eating disorder, especially those with anorexia nervosa (AN), have been reported to refuse treatment frequently despite being in mortal danger from malnutrition. Two types of non-voluntary hospitalizations are implemented for a person with a mental illness, such as schizophrenia, according to the law in Japan: “Involuntary Hospitalization” and “Hospitalization for Medical Care and Protection (HMCP).” The HMCP is applicable for a person who needs hospitalization for medical care and protection, and is not likely to hurt himself/herself or others because of the mental illness. He/she can be hospitalized as long as person responsible for his/her protection consent. In our previous work, 65–95% of the physicians selected the HMCP for a patient with AN, who is in mortal danger. However, there is little consensus on whether AN is a mental illness and whether a patient with AN is competent. Aim: We investigated the thoughts of members who engage in the review of an application for non-voluntary hospitalization. Methods: A self-administered questionnaire was sent to 180 members of the Psychiatric Review Board who consented to participate in the study. Results: The response rate was 42.8% (77/180). In cases where the patient had a short or long history and his/her family members agreed with inpatient treatment, 92.2% or 90.9% of the respondents thought that the HMCP was applicable. Further, 89.6% thought that AN was a mental illness. Additionally, 10.4% believed that patients with AN in mortal danger were fully competent, 51.9% thought they were partly competent, and the remaining 32.5% thought that they were incompetent. Conclusions: Most of the respondents thought that the HMCP was applicable to cases of treatment refusal by a patient with AN and that AN was a mental illness. On the other hand, some respondents considered the patients full or partly competent. A further discussion would be needed to resolve ethical challenges.

F089: What Changes in Illness and Recovery in Anorexia Nervosa?

Brooks Brodrick, MD; PhD, University of Texas Southwestern Medical Center, Dallas, Texas, Jessica Harper, BA, University of Texas Southwestern Medical Center, Dallas, Texas, Erin VanEnkevort, PhD, University of Texas Southwestern Medical Center, Dallas, Texas, Carrie McAdams, MD; PhD, University of Texas Southwestern Medical Center, Dallas, Texas

We were interested in understanding how clinical and cognitive symptoms differ for adult women with and recovered from anorexia nervosa, and how those symptoms change over time. In 2011-2014, we obtained cognitive and clinical data from 38 women recently with anorexia nervosa (AN-C, met DSM IV criteria for anorexia nervosa during prior 6 months). In 2015 and 2016, clinical symptoms and numerous cognitive assessments were re-assessed for 28 of these women. The women were then divided into those that had achieved recovery, defined by using only outpatient psychiatric providers during the preceding 12 months in concert with maintenance of a BMI > 19 for at least six months (AN-CR, n = 11), and those who relapsed or continued to have an eating disorder (AN-CC, n = 17), defined by having a BMI less than 19 during the preceding six months or requiring a higher level of care (inpatient, residential, partial hospital or intensive outpatient) in the preceding twelve months. We then compared whether the measures obtained initially or at follow-up differed for these two groups. The only factors that differed at baseline for the AN-CC and AN-CR groups were related to executive function, including slower times on both the Trails A and B (Trails A, mean AN-CC 26 s, AN-CR 20 s, p = 0.03; Trails B, mean AN-CC 45 s, AN-CR 35 s, p = 0.01) and more errors on the Wisconsin Card Sort (errors, mean AN-CC, 13, AN-CR 9, p = 0.01). Importantly, the scores on the eating disorder assessments (Eating Attitudes Test, Eating Disorder Questionnaire, and Body Shape Questionnaire) did not differ for these two groups at either baseline or at follow-up. However, differences in depression (QIDS, AN-CC 7, AN-CR 3, p = 0.002), anxiety (SIGH-A, AN-CC 9, AN-CR 5, p = 0.06), and self-esteem (Self-Competence, mean AN-CC 20, AN-CR 25, p = 0.08; Self-Liking, mean AN-CC 18, AN-CR 24, p = 0.04) were observed in the recovered group compared to the ill group at follow-up. These data suggest that neuropsychological function may be a predictor of course of illness, and that improvements in comorbid symptoms and self-esteem may precede changes in eating disorder symptoms during early recovery from anorexia nervosa.

F090: The Relationship Between Central Coherence, Eating Pathology, and Body Image Distortion

Ilana Ladis, Student, Wesleyan University, Middletown, Connecticut, Caitlin Shepherd, PhD, Wesleyan University, Middletown, Connecticut

Previous studies have found that poor global processing and strong local processing are evident in patients with eating disorders, suggesting that weak central coherence may represent an endophenotype. The current study aimed to fill a gap in the research by examining how global and local processing are related to eating pathology and body image distortion in a non-clinical sample. Forty-nine female undergraduate students completed computer-based tests of global and local processing using the Cogstate program. Participants were assessed for eating pathology and body image distortion using the Eating Disorder Examination Questionnaire (EDE-Q) and the Body Image Assessment Scale-Body Dimensions (BIAS-BD). Global processing was significantly negatively correlated with overall eating pathology (r = -.35, p < .05), shape concern (r = -.42, p < .01), and weight concern (r = -.34, p <.05). Local processing was significantly positively correlated with restraint (r = .29, p < .05). In addition, an independent samples t-test revealed that global processing performance was significantly poorer for those with higher eating pathology (M = .72, SD = .14) compared to those with lower eating pathology (M = .80, SD = .11), t (46) = 1.94, p = .05. A multiple linear regression analysis also revealed a significant interaction between eating pathology and body image distortion, F(3, 44) = 4.26, p = .01. For individuals with higher eating pathology, increased body image distortion was associated with better local processing performance. Findings from this study support the link between weak central coherence and eating disorder symptomatology in a non-clinical sample. These findings suggest that targeting weak central coherence may be a useful prevention and intervention strategy for decreasing eating disorder symptomatology. Cognitive Remediation Training, which has shown some success in clinical populations, could be adapted and applied for those deemed at risk for eating disorders.

F091: Examining Lean Ideal Internalization and Its Association with Eating Pathology in Men and Women

Lauren Schaefer, MA, University of South Florida, Tampa, Florida, Diana Rancourt, PhD, University of South Florida, Tampa, Florida, Brittany Lang, BA, University of South Florida, Tampa, Florida, Natasha Burke, PhD, Uniformed Services University of the Health Sciences, Bethesda, Maryland, David Frederick, PhD, Chapman University, Orange, California, Mackenzie Kelly, PhD, Rush University Medical Center, Chicago, Illinois, Drew Anderson, PhD, State University of New York, Albany, New York, Katherine Schaumberg, PhD, University of North Carolina, Chapel Hill, North Carolina, Kelly Klump, PhD, Michigan State University, East Lansing, Michigan, Allison Vercellone, MA, Saint Louis University, St. Louis, Missouri, J. Kevin Thompson, PhD, University of South Florida, Tampa, Florida

Drive for leanness (DL) is conceptualized as a desire for “low body fat and toned, physically fit muscles,” which may increase risk for disordered eating. DL is associated with negative body image; however, direct relationships with disordered eating have not been explored. Moreover, current measures of DL focus largely on having “well-toned” muscles and do not explicitly address a concurrent desire for lower body fat. As thin and muscular ideal internalization are implicated in the etiology of maladaptive eating behaviors, it is possible that their additive effects – internalization of a lean ideal (i.e., high thin and high muscular ideal internalization) – may confer greater risk for disordered eating. To examine this, 271 male and 810 female undergraduates were divided into four internalization categories using the Sociocultural Attitudes Towards Appearance Questionnaire-4 Internalization: Thin/Low Body Fat and Internalization: Muscular/Athletic subscales. Median splits were used to represent individuals reporting only high thin ideal internalization (HT), only high muscular ideal internalization (HM), high lean ideal internalization (HL; i.e., both HT and HM), and low appearance ideal internalization (LA; i.e., low levels of thin and muscular ideal internalization). ANOVAs within gender revealed significant differences between internalization groups’ Eating Disorder Examination-Questionnaire global scores. Post-hoc analyses among women indicated that eating disorder risk was highest within the HT and HL groups relative to those in the HM and LA groups. Men who endorsed HT and HL reported significantly higher disordered eating risk relative to peers in the LA group; however, levels of disordered eating risk did not significantly differ between men with HM and other internalization groups. Overall, the hypothesis of additive effects was not confirmed, with the majority of eating disorder risk conferred by a desire for thinness, particularly among women.

F092: The Moderating Role of Sleep Duration in the Relationship between Eveningness and Disinhibition

Taylor Perry, Student, University of North Dakota, Grand Forks, North Dakota, Terra Towne, MA, University of North Dakota, Grand Forks, North Dakota, Kyle De Young, PhD, University of Wyoming, Laramie, Wyoming

Disinhibited eating is eating in an unrestrained, opportunistic manner. Some evidence suggests that dim lighting in the evening facilitates disinhibition by undermining self-regulation. Indeed, individuals who report increased alertness and greater activity in the evening (i.e., those high in eveningness) report higher levels of disinhibition than morning-oriented people. It is unknown how sleep duration may affect this relationship. Short sleep duration predicts weight gain among individuals high in disinhibition and is associated with changes (i.e., increased hunger hormones, decreased dietary restraint, and sensitivity to food-related rewards) that may catalyze disinhibition. This study examined sleep duration as a moderator of the relationship between eveningness and disinhibition. We hypothesized that this relationship would be strongest among individuals who sleep less. Undergraduate men (n=34) and women (n=109) reported their height and weight and completed the Three Factor Eating Questionnaire, Pittsburgh Sleep Quality Index, Eating Disorder Examination-Questionnaire, and Morningness-Eveningness Questionnaire. Multiple linear regression tested the relationship between disinhibition, eveningness, and past-month sleep duration. The overall model was significant (F(5,137) = 12.65, p<.001) and explained 29.1% of variance in disinhibition. After adjusting for BMI and weight/shape concerns, there was a significant eveningness by sleep duration interaction effect. As hypothesized, individuals high on eveningness who reported shorter sleep experienced the highest levels of disinhibition. Among longer sleepers, there was no relationship between eveningness and disinhibition. These findings suggest that evening-oriented people are more likely to experience disinhibition when sleep is restricted. As such, experimental research should test whether increasing sleep duration reduces disinhibition in evening-oriented people, identifying it as a potential treatment target.

F093: Exercise Addiction: Exploring the Contribution of Exercise Dependence to Eating Disorder Symptoms

Leigh Brosof, BA; Student, University of Louisville, Louisville, Kentucky, Cheri Levinson, PhD, University of Louisville, Louisville, Kentucky, Laura Fewell, BA, University of Louisville, Louisville, Kentucky

Exercise dependence is a set of cognitive and behavioral symptoms that constitute a reliance on exercise, possibly in response to negative emotions, and is related to eating disorder (ED) symptoms. There are seven components of exercise dependence: tolerance (increased exercise needed for same effects), withdrawal (withdrawal symptoms present with reduced exercise), continuance (continued exercise despite psychological or physical problems), lack of control (inability to exercise less), reduction in other activities (activities given up for exercise), time (excessive time exercising), and intention effects (exercise for longer than intended). It is not known which components of exercise dependence contribute to ED symptoms. The current study (N = 147 individuals diagnosed with an ED) investigated 1) which components of exercise dependence relate to ED symptoms, and 2) if exercise dependence relates to ED symptoms when accounting for negative affect. Participants completed self-report measures of ED symptoms, exercise dependence, and negative affect. We first tested a model including all components of exercise dependence predicting ED symptoms: continuance, withdrawal, tolerance, and time predicted (ps ≤ .038) ED symptoms, whereas lack of control, reduction in other activities, and intention effects did not (ps ≥ .104). We then tested continuance, withdrawal, tolerance, and time in a model predicting ED symptoms, controlling for negative affect. We found that only tolerance (b* = .31, p = .003) positively predicted ED symptoms above and beyond negative affect (b* = .61, p < .001). In the presentation, we will test if these findings hold across one month. Tolerance was the component of exercise dependence that predicted ED symptoms, even when controlling for negative affect. If future research supports these findings, treatment centers may consider gradually reducing exercise, rather than abruptly halting exercise, which may prevent sudden increases in ED symptoms.

F094: Variability in Approach to Inpatient Medical Stabilization of Patients with Avoidant/Restrictive Food Intake Disorder

Sara Forman, MD, Boston Children's Hospital, Boston, Massachusetts, Carly Guss, MD, Boston Children's Hospital, Boston, Massachusetts, Tracy Richmond, MPH; MD, Boston Children's Hospital, Boston, Massachusetts

The aim of this study was to determine the current protocols and practices used by Adolescent Medicine providers for inpatient medical stabilization of patients with Avoidant/Restrictive Food Intake Disorder (ARFID) in the United States. An anonymous survey was emailed to United States-based physician members of the Society for Adolescent Health and Medicine Eating Disorder Special Interest Group listserve and the National Eating Disorders Quality Improvement Collaborative. Forty-five percent of 83 eligible physicians completed the survey; 73.0% (n=27) of respondents admitted patients with ARFID for medical stabilization. Providers who admitted patients with ARFID tended to be academically based. Of those who admitted patients with ARFID for medical hospitalization, 50% reported not using any protocol for nutritional resuscitation. Of providers who used a protocol (n=11), 54.5% (n=6) used the same protocol developed for anorexia nervosa (AN). Only 22.7% (n=5) reported having a non-AN refeeding protocol for refeeding ARFID patients. “Regular food” was the most common form of nutrition used for nutritional resuscitation and was used by over 90% of respondents. Feeding via nasogastric tubes was used by half of providers and was provided as the initial feeding regimen, a nocturnal supplement, or in some other manner. Multidisciplinary teams were common, and few physicians reported that they typically prescribed medications. In free text responses participants indicated that ARFID needs to be treated differently than AN and that use of a multidisciplinary approach with additional services such as behavior modification/exposure therapy is important. Survey respondents demonstrated considerable variability in their treatment approach to hospitalized patients with ARFID, perhaps due to the limited evidence-base for treatment of this illness. An important next step is to test the efficacy of protocols for anorexia nervosa in treating ARFID patients.

F095: Adherence and Efficacy of Family-Based Treatment (FBT) in Studies of Youth with Anorexia Nervosa: A Critical Review of the Literature Examining Fidelity to FBT Approach and its Application in a Clinical Setting

Afeeq Zambre, Student, University College Dublin, Dublin, Leinster, McNicholas Fiona, DClinPsy; MB; MD; FRCPsych, MRCPsych, University College Dublin, Dublin, Leinster, Lesley O'Hara, BA; MSc; PhD, University College Dublin, Dublin, Leinster

Family-Based Treatment (FBT) is considered first line treatment for children/adolescents with Anorexia Nervosa (AN)1. Key components include empowering the parents to refeed their child, seeing the family as a resource, regular patient weighing, initial focus on weight restoration prior to considering other adolescent/family difficulties2. Despite the existence of evidenced based approaches, and a clinicians’ manual guiding FBT method, it is well recognised that clinicians in general, and with ED cohorts, display significant divergence from evidenced models, especially as treatment moves from a research centre to community settings, limiting conclusions that can be drawn of treatment efficacy. This study aimed to systematically review outcomes studies using FBT for AN and examining if fidelity to the manualised approach could be ascertained. PubMed, Web of Science, PsycINFO and PsycARTICLES were searched, 524 studies identified, full text analysis conducted in 63, identifying 17 studies meeting inclusion criteria. A fidelity checklist was constructed containing fundamental tenets guiding FBT1 and studies examined against this and grouped into 50%, 75% and 100% fidelity. Papers used various outcome measures including weight restoration, return of menses and psychological symptom improvement. FBT reported success in all 17 studies examined. Although 16 studies referenced the treatment manual, no study provided sufficient information to conclude 100% fidelity, the majority (15) having scores below <50%, with no link between outcomes and fidelity. The existing literature does not provide enough data on adherence to FBT in AN treatment to allow readers to determine whether FBT was delivered as intended, or what elements of FBT might be crucial to successful outcomes. Identifying essential FBT elements ensure that community delivery maintain these features. Evaluation of clinicians’ adherence to the model is also essential to ensure that young people are being offered best practice. Despite frequent use of FBT, few studies reported model adherence. Routine fidelity checklist use in clinical practice and publications would improve confidence in treatment delivery and study results and help in ascertaining essential model ingredients.

F096: Brief CBT for Non-Underweight Eating Disorders: Findings From Two Case Series

Glenn Waller, BA, MPhil; DPhil; FAED, University of Sheffield, Sheffield, Yorkshire, Hannah Turner, BSc; PhD; DClinPsy, Southern Counties Eating Disorders Service, Southampton, Hampshire, Madeleine Tatham, BSc; DClinPsy, Norfolk Eating Disorders Service, Norwich, Norfolk, Victoria Mountford, BSc; DClinPsy, South London and Maudsley Eating Disorders Service, London, UK

Brief, 10-session cognitive-behavioural therapy (CBT) can be as effective as longer versions in treating depression and anxiety, even when delivered by clinicians with lower levels of qualifications. Recent evidence from a case series has demonstrated similar outcomes in non-underweight eating disorders, with positive results from a 10-session intensive CBT, delivered by graduate clinicians. However, that finding needs to be supported by follow-up data, and replication. The aim of this paper is to address these two gaps. In the first of two case series, follow-up data are presented from a study that began with over 100 eating-disordered patients. The follow-up data indicate that the original remission levels are well maintained into the longer term (three months), using both completer and intention to treat analyses. The second study reports a replication of the original case series, showing that outcomes by the end of treatment were very similar to those of the first case series. These findings require comparison of this intensive version of CBT with other therapies, including full length CBT for eating disorders, and to be replicated in other settings. However, they indicate that an intensive CBT over 10 sessions is a viable option for effective and less costly treatment of non-underweight eating disorders.

F097: Body Checking in Non-Clinical Women: A Real Life Experimental Study of Negative Impact on Eating Pathology

Glenn Waller, BA; MPhil; DPhil; FAED, University of Sheffield, Sheffield, Yorkshire, Natalie Bailey, BSc, University of Sheffield, Sheffield, Yorkshire

Body checking is a safety behaviour that is correlated with negative eating attitudes in clinical and non-clinical samples. However, there is little evidence of a causal link between the two. One lab-based experimental study has supported the proposed link, but there is a need for more ecologically valid experimental studies to demonstrate the effects of body checking. This study aimed to determine whether body checking results in negative eating attitudes in a real life setting. Fifty non-clinical women completed initial measures of body checking and eating pathology, then completed a body checking task on one day (checking their wrist every 15 minutes for 8 hours) and refrained from body checking on the other day (order counterbalanced). Measures of eating attitudes and body dissatisfaction were completed each day, two hours after the manipulation. Body dissatisfaction did not increase significantly after body checking. In contrast, a specific central eating disorder cognition - fear of uncontrollable weight gain in response to eating - significantly increased after body checking. That increase was greater in individuals with higher trait disordered eating attitudes. Though they need to be replicated and extended in a clinical sample, these findings suggest that body checking has a specific impact on fear of uncontrollable weight gain – a key element in understanding the behaviours that underpin eating disorders. Therefore, it can be suggested that interventions that address body checking should be a routine part of treatment where that behaviour is present, to reduce the level of such cognitions.

F098: The Prevalence of ADHD and Binge Eating among Patients at a Bariatric Surgery Clinic

Jennifer Bleck, MPH; PhD, University of South Florida, Tampa, Florida, Rita DeBate, MPH; PhD, of South Florida, Tampa, Florida, Marilyn Stern, PhD, University of South Florida, Tampa, Florida

ADHD is associated with both binge eating and obesity. Moreover, ADHD may impact both weight loss success and maintenance among patients seeking obesity treatment. Despite the potential impact on the patient’s success, surgical obesity treatment centers do not routinely evaluate for ADHD as part of standard patient intake assessments, limiting the current literature on the effects of the ADHD/obesity comorbidity. This study aimed to explore the prevalence of ADHD and binge eating among bariatric surgery patients. Data was collected through both medical chart reviews and survey collection at a bariatric surgery clinic. ADHD was evaluated using the Wender Utah Rating Scale for self-reported childhood ADHD symptoms and the self-report Conners’ Adult ADHD Rating Scale for current symptoms. Binge eating was assessed via self-report during an initial psychology assessment. Data was obtained from 50 patients (39 females, 11 males). Age ranged from 23 to 65 (mean=46.52), and body mass index ranged from 33.68 to 76.46 (mean=47.90). Elevated prevalence of clinically concerning ADHD symptomology was noted; 11.5% reported a history of childhood symptoms, and 46.2% reported current ADHD symptoms. Moreover, 15.4% of patients reported a history of binge eating behavior, one patient reported a diagnosis of Bulimia and another reported purging behavior. Findings suggest an increased prevalence of ADHD and binge eating among obese patients seeking bariatric surgery and provide evidence for the need of standard screening policies. Continued investigation is needed to determine the prevalence of diagnosable cases vs. subclinical behaviors as well as the impact of these co-occurrences on treatment success.

F099: An Exploration of Binge Eating Disorder Patient Rationale for Seeking Eating Disorder Treatment: Is the Rationale Itself Eating Disordered?

Caitlin Martin-Wagar, BA; MA, The University of Akron, Akron, Ohio, Kelly Bhatnagar, PhD, The Emily Program, Beachwood, Ohio

While Binge Eating Disorder (BED) is the most commonly occurring eating disorder, affecting approximately 2.6% of the general population in the United States, little is known about why individuals with BED seek treatment. An understanding of what factors influence motivation for treatment in treatment seeking BED clients is needed to better prepare clients for change and to support them in achieving recovery. Additionally, addressing any motivation rooted in eating disorder cognitions (such as desire to lose weight or “look better”) is important to prevent relapse. Understanding clients’ values can enhance motivation within treatment and the treatment team can use the clients’ own goals and value system to increase and sustain motivation for change. Patients upon admission to a BED-IOP (N=24) completed open-ended questionnaires regarding their motivation for seeking treatment. Through thematic analysis, several main themes emerged, such as wanting change from persistent negative mood, thought patterns, and unhealthy behaviors; feeling that weight loss attempts have not addressed deeper issues; having tried multiple weight loss attempts with no long-term success; and wanting to look better. Taken together, many of the explanations patients provided regarding their treatment seeking motivations were mental and physical health-based. However, the appearance-related theme emerged for the majority of patients, even if they also indicated health-related motivation for treatment. Research findings can help treatment providers investigate and target eating disordered motivations for seeking treatment early in the treatment process. Additionally, loved ones, mental health practitioners, and medical providers can capitalize on these health-related motivations to encourage and engage individuals with BED into treatment.

F0100: Drives for Muscularity and Thinness: Associations with Age and Gender

Erica Ahlich, BA, University of South Florida, Tampa, Florida, Brittany Lang, MA, University of South Florida, Tampa, Florida, Diana Rancourt, PhD, University of South Florida, Tampa, Florida

Notions about the ideal body, and perceptions about how one’s own body differs from this ideal, may differ between men and women, as well as between younger and older adults. Research examining body dissatisfaction across the lifespan has primarily focused on females and a desire for thinness; however, males are increasingly reporting body dissatisfaction, and consistent with an increased cultural emphasis on leanness, both males and females may be motivated to achieve both thinness and muscularity. Men’s and women’s desire to be thin or muscular and whether these desires vary across the lifespan remains unexplored. The current study examined these associations in a sample of 1068 adults recruited from Amazon’s Mechanical Turk. Participants were 59.7% female, ranging in age from 18 to 66 years old, with 53.5% of participants aged 35 or younger. Controlling for participant BMI (M = 27.18, SD = 6.69), multiple linear regression analysis indicated that age and gender were both significant predictors of drive for thinness (DT). On average, females reported a higher DT than men, and DT showed a decline across age for both genders. Although no age by gender interaction emerged for DT, the association between age and drive for muscularity (DM) did differ by gender. Among men, age was a significant predictor of drive for muscularity, such that levels were higher in younger adults and decreased with age. For women, DM was low regardless of age. Overall, the findings suggest that concerns about muscularity and thinness appear to be less salient in middle to older adulthood than in younger adulthood; however, gender is an important consideration. Men reported concern with both thinness and muscularity in young adulthood, both of which decreased over time, whereas women were primarily concerned with thinness.

F101: The Long Road to Recovery: Treatment and Costs of Adolescent Anorexia Nervosa in Specialized Care

Yasmina Silén, MD, University of Helsinki, Helsinki, Uusimaa

The aim of the current study was to evaluate the treatment and costs in a specialized eating disorder unit for adolescents. All patients with ICD-10 anorexia nervosa (n = 34) or atypical anorexia nervosa (n = 13) whose treatment at the Eating Disorder Unit for Adolescent at Helsinki University Central Hospital was completed within one year (12.3.2012-30.4.2013) were included in the study. A systematic retrospective review of adolescents’ medical records and hospital administrative data was conducted, and treatment costs, the number of outpatient visits and length of in-patient treatment were obtained. Treatment outcome was defined using Morgan-Russell criteria. We observed vast individual differences in the need and the cost of treatment. Overall, 60 % of patients recovered. More than quarter of patients needed treatment at multiple wards. The majority of the costs (76%) arose from the treatment of a minority (29 %) of patients. Psychiatric comorbidity was associated with longer and more expensive treatments. Adolescents with long and costly treatments did not significantly differ in their outcome from other patients. To conclude, treatment for severe anorexia nervosa is expensive, but with intensive treatment many recover. Future studies should focus how improve the care of adolescents with psychiatric comorbidity.

F102: Confirmatory Factor Analysis of an Instrument Assessing the Obesogenic Environment Among Families in Spain

Melissa Parks, MSc; PhD Autonomous University of Madrid, Madrid, Spain, Miriam Blanco, MSc; PhD, Autonomous University of Madrid, Madrid, Spain, Santos Salano, MSc, Autonomous University of Madrid, Madrid, Spain, Tatiana Lacruz, MSc, Autonomous University of Madrid, Madrid, Spain, Francisco Javier Roman, PhD, University of Illinois, Urbana-Champaign, Urbana-Champaign, Melissa Parks, PhD, Autonomous University of Madrid, Madrid, Spain, Montserrat Graell, PhD, Hospital Universato Nino Jesus, Madrid, Spain, Ana Rosa Sepulveda, PhD, Autonomous University of Madrid, Madrid, Spain

At present, childhood obesity is an issue of great relevance. In Spain in particular, it is estimated that 26.3% of children present some degree of overweight. Physical activity and diet are crucial variables influencing nutritional status and energy balance and largely depend on the environment in which the child is raised. The aim of this study was to employ a confirmatory factor analysis (CFA) to validate the Spanish version of the Home Environment Survey (HES-S) among a sample of 145 parents of preadolescents and compare it to the conceptual model of the home obesogenic environment, composed of eating and physical activity components, proposed by the authors of the original HES study (Gattshall et al., 2008). The original HES was composed of four subscales concerning physical activity and six subscales assessing eating habits. However, no CFA was carried out in the validation of the original instrument. Our results replicated the original four factor structure proposed for physical activity, but the original factor structure of the eating habits component was not supported. However, both the physical activity component and the eating habits component showed excellent levels of internal consistency. Correlations with related variables (Family eating habits questionnaire, data regarding children’s physical activity obtained from use of accelerometers and the Short-form International Physical Activity Questionnaire) supported the convergent validity of the instrument. In conclusion, the HES-S is an acceptable and valid instruments to assess the obesogenic environment in Spanish children.

F103: Changes in the Clinical Characteristics of Eating Disorders: A Cross-Sectional Comparative Study across Turkish Eating Disorder Patients from Two Distinct Time Frames

Basak Yucel, MD; Prof., Istanbul University, Istanbul Faculty of Medicine, Psychiatry Department, Istanbul, Istanbul, Turkey, Hanife Ozlem Sertel Berk, Assoc. Prof., Istanbul University, Faculty of Letters, Department of Psychology, Istanbul, Istanbul, Turkey, Ezgi Deveci, PhD Candidate, Işık University, Faculty of Arts and Sciences, Department of Psychology, Istanbul, Istanbul, Turkey, Basak Ince, Student, Arel University, Faculty of Arts and Sciences, Department of Psychology, İstanbul, Istanbul, Turkey

Literature has suggested the influence of different time trends on the clinical characteristics of eating disorders (EDs). Although demographic and clinical characteristics of Turkish EDs patients have recently been reported, there is a lack of knowledge about the effect of time trends on these patients. Thus, this research conducted as a consecutive study following to this report aimed to examine how the prevalence, age onset, body mass index (BMI), duration of illness, and comorbid psychiatric problems differed between two samples of Turkish participants diagnosed with eating disorders from two different time frames. A further aim was to investigate how these factors changed among subtypes of EDs based on DSM – IV, namely anorexia nervosa (AN), bulimia nervosa (BN), and eating disorders otherwise diagnosed (EDNOS). Patients with EDs were recruited from a university hospital and a private practice clinic in Istanbul, Turkey. 110 patients aged between 12-40 from the period of 2002 to 2009 (Time1) and 106 patients aged between 12-42 from the period of 2010 to 2015 (Time 2) participated this study. A diagnostic interview was conducted with the patients, and patients were asked to fill out questionnaires measuring EDs pathology, body satisfaction, self-esteem, depression, anxiety and alexithymia. Results of main analysis revealed a main effect of time on mean BMI and depression scores indicating increase from Time 1 to Time 2, but not on mean duration of illness and frequency of ED diagnosis. With respect to analysis conducted within each ED subtype, although BMI scores were slightly higher in Time 2 for all ED types, these differences were not significant. Under the light of these findings, it will be worth discussing the effect of changing patterns of socio-cultural factors and media on increased depression and BMI levels of EDs patients. Keywords: eating disorders, time effect, depression, body mass index, age onset

F104: An Investigation of Demographic and Clinical Characteristics of Turkish Eating Disorders Patients

Hanife Ozlem Sertel Berk, Assoc. Prof, Istanbul University, Faculty of Letters, Department of Psychology, Istanbul, Turkey, Basak Yucel, MD, Istanbul University, Faculty of Medicine, Department of Psychology, Istanbul, Turkey, Basak Ince, Arel University, Department of Psychology, Instanbul, Turkey, Ezgi Deveci, PhD Candidate, Isik University, Faculty of Arts and Sciences, Department of Psychology, Istanbul, Turkey

A growing literature has demonstrated that Eating Disorders (EDs) are not Western specific illnesses, and the prevalence rates of EDs in non-Western countries are increasing. Besides increased awareness, there is still a limited knowledge about the demographic and clinical representations of EDs in non-Western societies. In this regard, the current study aimed to investigate demographic and clinical characteristics of EDs based on DSM – IV criteria, anorexia nervosa (AN), bulimia nervosa (BN), and eating disorders not otherwise diagnosed (EDNOS), in Turkish society. A sample of 106 patients (102 female, 4 male) with the mean age of 21.85 (SD = 5.95) participated to this study. Patients were recruited from a university hospital and a private practice clinic in Istanbul, Turkey. Following a diagnostic interview, patients completed a questionnaire package consisting measures of eating pathology, alexithymia, body dissatisfaction, depression, anxiety and self-esteem. Analysis showed that age onset of AN patients was significantly lower than other patients while there was no significant difference between the age onset of BN and EDNOS patients. Regarding body mass index (BMI) of the patients, as expected, mean BMI of the AN patients were found to be significantly lower than other patients. Furthermore, there was only a significant difference between AN, BN and EDNOS patients for their BDI scores where EDNOS patients had the highest depression levels. In terms of demographic characteristics, it was found that there was no significant difference between subtypes of EDs about referral type, education and working status since most of the patients were high school and university students. Based on the current findings, it will be worth discussing the possible factors (e.g., lack of male patients, definition of beauty and accessibility to health care) that trigger differences between Western and non-Western countries regarding demographic and clinical features of EDs patients.

F105: Boys and Eating Disorders: Patient’s Profile from an Eating Disorders Center of Sao Paulo, Brazil

Alicia Cobelo, MS; FAED, Institute of Psychiatry,University of São Paulo School of Medicine, Sao Paulo, Brazil, Felipe Alckmin-Carvalho, MS, Institute of Psychiatry, University of São Paulo School of Medicine, Sao Paulo, Brazil, Juliana Vega, MS; FAED, Institute of Psychiatry, University of São Paulo School of Medicine., Sao paulo, Brazil, Alessandra Fabbri, MS, Institute of Psychiatry, University of São Paulo School of Medicine, Sao Paulo, Brazil, Vanessa Pinzon, MS; FAED, Institute of Psychiatry, University of São Paulo School of Medicine, Sao Paulo, Brazil

The prevalence of eating disorders (ED) in males has increased in recent years. Investigate this population is critical to improve the specialized treatment. The aim of this research is describe clinical and socioeconomic variables of outpatients younger than 18 years and their caregivers assisted at PROTAD, an ED center in Brazil. We conducted a cross-sectional study based on data analysis of medical records related at the start of the treatment. A descriptive analysis was performed, including mean, standard deviation and minimum and maximum values (SD/min-max) expressed as numerical variables and percentages for categorical variables. From 2001 to 2015, 188 pacients were admited at PROTAD, and 20 (10.6%) were boys. The mean age at onset of ED was 14 years old (2.0, 8.00-16.42), and the age at the beginning of treatment was 15.1 years (1.38; 12.73-17.16). Mean Body Mass Index (BMI) was 17.17 kg/m2 (3.93; 12.86-26.86), and half of the patients had a BMI

F106: Underlying Trait or Transient State? An Exploration of Autism Spectrum Disorder in Adolescent Females with Anorexia Nervosa

Heather Westwood, BSc; Student, King's College London, London, UK, Mima Simic, MSc; MD; MRCPsych, South London and Maudsley NHS Foundation Trust, London, UK, William Mandy, BA; DClinPsy; PhD, University College London, London, UK, Kate Tchanturia, DClinPsy; PhD; FAED, King's College London, London, UK

The aim of this study was to use standardised, clinical assessment tools to explore the presence of ASD symptoms in a sample of adolescent females with AN and to determine whether any such symptoms were present during the developmental period, a requirement for ASD diagnosis. Using a cross-sectional design, 40 females aged between 12 and 18 were recruited from inpatient and day patient eating disorder services. All participants had a diagnosis of AN and were assessed for symptoms of ASD using the Autism Diagnostic Observation Schedule, 2nd edition (ADOS-2). If participants scored above clinical cut-off on the ADOS-2, their parents were also asked to complete the Developmental, dimensional and diagnostic interview, short version (3Di-sv). Of the 40 participants assessed, half scored above cut-off on the ADOS-2. However, when developmental history was obtained, only four scored above cut-off on the 3Di-sv, suggesting a developmental history of ASD, despite not being previously diagnosed. The results of this study suggest that 10% of adolescents diagnosed with AN may have diagnosable ASD, while a further 40% may show symptoms of ASD, representing an epiphenomenon which arises from the ill-state of AN.

F107: Assessing Alexithymia in Females with Anorexia Nervosa Using a New Observation-Based Coding Schedule: A Case-Control Study

Heather Westwood, BSc; Student, King's College London, London, UK, Fiona McEwen, PhD, Queen Mary University of London, London, UK, Kate Tchanturia, DClinPsy; PhD; FAED, King's College London, London, UK

The aim of this study was to pilot a new observation-based measure of alexithymia, namely the Alexithymia Coding Schedule (ACS) with a sample of females with Anorexia Nervosa (AN) and a comparison group of healthy female university students and staff. The ACS was developed to provide a brief, observation based, objective measure of alexithymia in clinical populations, for use as an addition to self-report measures, which may be influenced by the insight of the patient. The ACS is a clinician-led interview consisting of ten questions focusing on recognising and describing various emotions. The questions were taken directly from Module 4 of the Autism Diagnostic Observation Schedule, 2nd Edition (ADOS-2) but specific scoring for alexithymia has been developed so that it may also be used as a stand-alone assessment. Sixty adult females with AN and 50 healthy females completed the ACS and the Toronto Alexithymia Scale (TAS-20). The AN group scored significantly higher on the ACS, in both recognising and describing emotions, suggesting higher levels of alexithymia. This scores on the ACS were corroborated by the TAS-20, on which the AN group also scored significantly higher than controls, suggesting that the ACS may be a viable addition to self-report measures of alexithymia in AN.

F108: Social Comparison and Objectification Theories: Interracial Comparisons of an Integrated Model

Brittany Lang, MA, University of South Florida, Tampa, Florida, Diana Rancourt, PhD, University of South Florida, Tampa, Florida, Lauren Schaefer, PhD, University of South Florida, Tampa, Florida, Jennifer Bosson, PhD, University of South Florida, Tampa, Florida, Kevin Thompson, PhD, University of South Florida, Tampa, Florida

Social Comparison and Objectification Theories of disordered eating have received strong empirical support in primarily White samples, with some evidence suggesting that these models may operate somewhat differently in individuals of diverse racial/ethnic backgrounds. Recent work supports an integration of Social Comparison and Objectification frameworks; however, research has not yet examined potential ethnic differences in this integrated model. This study explored the extent to which an integrated model of Objectification and Social Comparison Theories similarly predicted body image and eating disturbance across racially/ethnically diverse young adult women. African American (N=66), Asian (N=27), Hispanic (N=73), and White (N=343) women (age M=20.9, SD=4.6; BMI M=23.8, SD=5.2) completed validated measures of self-surveillance (Policing of Appearance Scale), appearance comparisons (Physical Appearance Comparison Scale – Revised), body shame (Objectified Body Consciousness Scale – Body Shame subscale), body image disturbance (Multidimensional Body-Self Relations Questionnaire – Appearance Evaluation subscale), and eating disturbance (Eating Disorder Examination Questionnaire global scores). A multiple group structure equation model was estimated using full information maximum likelihood in MPlus to test whether the model differed across racial/ethnic groups. The final model demonstrated a good fit to the data, (X2(80) = 99.47, p = .069, CFI = .98, RMSEA = .04), and supported an integrated model of Objectification and Social Comparison Theories. Contrary to previous work demonstrating racial/ethnic differences in appearance comparison and objectification processes, the integrated model fit similarly across all four racial/ethnic groups. Only the strength of the association between appearance comparisons and body shame varied across groups. This association was strongest among Asian women and weakest among Black women. Findings suggest that when combined, self-surveillance and social comparison processes may similarly predict eating disorder risk among diverse women.

F109: Using the Electronic Medical Record (EMR) to Identify Quality Improvement Targets for Patients with Eating Disorders

Kim Lazare, MD, University of Toronto, Toronto, Ontario

The purpose of this study is to review Electronic Medical Record (EMR) data of Eating Disorder (ED) patients in a primary care setting to assess whether they are receiving appropriate medical management, and to identify targets for Quality Improvement (QI) of care. The study took place at a Family Health Organization (FHO) located within a suburban teaching hospital in Toronto, Ontario, comprised of four female family physicians caring for 2,916 patients. A EMR search for patients with an active ED diagnosis (Anorexia Nervosa (AN), Bulimia Nervosa (BN), Binge Eating Disorder (BED), or Eating Disorder Not Otherwise Specified (ED-NOS)) identified twenty-five patients. Five patients were excluded due to the patient only being seen once, having no data pertaining to their ED on the chart, or an error in documentation i.e. past history of ED documented inappropriately as active ED on the chart. Then, a chart review of the twenty patients was conducted, looking to see whether the following metrics were recorded on the chart in the past twelve months: weight, Body Mass Index (BMI), orthostatic vital signs, electrocardiogram (ECG), Bone Mineral Density (BMD), laboratory investigations including extended electrolytes, comorbid diagnoses, and medications. Fifteen (75%) of patients had a weight and BMI documented on the chart. Thirteen (65%) had orthostatic vital signs documented. Thirteen (65%) had labs including electrolytes documented on the chart. Of the patients with BN, all six patients (100%) had labs done. Five (71%) of AN patients had labs done. Fifteen (75%) patients had a ECG documented on the chart. Of the AN cohort, five (86%) had a ECG documented on the chart. None of the patients were on a medication that is absolutely or relatively contraindicated in ED. Only three (15%) of patients had a BMD documented on their chart. Charts of those patients without the aforementioned metrics completed were flagged for their Family Physician (FP) to organize any incomplete investigations to ensure all patients were receiving the same standard of care pertaining to medical management of their ED. This study details a simple and effective way to use the EMR to identify ED patients and ensure that they are receiving appropriate and high quality medical management in a primary care setting.

F110: How Do You Recruit College Students to Complete an Online Screen for Eating Disorder Intervention and Prevention Programs?

Neha Goel, BA, Stanford University, School of Medicine & Palo Alto University, Stanford & Palo Alto, California, Rachael Flatt, BS, Stanford University, School of Medicine & Palo Alto University, Stanford & Palo Alto, California, Shiri Sadeh-Sharvit, PhD, Stanford University, School of Medicine, Stanford, California, Ellen Fitzsimmons-Craft, PhD, Washington University in St. Louis, School of Medicine, St. Louis, Missouri, Katherine Balantekin, PhD; RD, Washington University in St. Louis, School of Medicine, St. Louis, Missouri, Grace Monterubio, BA, Washington University in St. Louis, School of Medicine, St. Louis, Missouri, Mickey Trockel, MD; PhD, Stanford University, School of Medicine, Stanford, California, Denise Wilfley, PhD, Washington University in St. Louis, School of Medicine, St. Louis, Missouri, C. Barr Taylor, MD, Stanford University, School of Medicine & Palo Alto University, Stanford & Palo Alto, California

Although eating disorders (EDs) prevalence among college students is high, less than 20% receive treatment. To improve health care utilization and reduce health complications of EDs, more effective practices may be needed to reach this population. This study explored the recruitment strategies that yielded greatest participation in an online screen for the Healthy Body Image (HBI) program. HBI offers a suite of mobile interventions for individuals across the ED risk and diagnostic spectrum. Participants were 4566 college students from 27 campuses across the United States and were on average 22.3 years old, 86.8% female, and 68.0% Caucasian, 17.5% Asian and 8.4% African American. This program was implemented via a variety of recruitment methods including email outreach, partnerships with local student health centers (LSHC), flyer distribution and more. The distribution of these categories for each group is as follows: potential anorexia nervosa (n=154), 43.7% selected email outreach that included a link to the screen, 16.7% received a referral from LSHC, 10.9% saw a flyer; females who met the DSM-V criteria for sub-clinical and clinical EDs (n=807), 41.3% selected email, 16.6% received a referral and 12.4% saw a flyer; high-risk group (n=1631), 53.3% selected email, 12% received a referral, and 10% by flyer; low-risk group (n=1893), 56.8% selected email, 6.8% received a referral, and 8% by flyer. Overall, 51.9% selected email, 10.9% were referred by LSHC, and 9.7% saw a flyer. Findings suggest that email outreach was the most effective method of recruitment for college students. However, those who are at a greater risk for developing an ED or already exhibit increased symptoms tend to be recruited in higher proportions through LSHC relative to low-risk groups. Given its low cost, universal screening methods should be implemented through systematic email distribution. Targeted prevention and treatment efforts should also be supplemented by partnerships with LSHC.

F111: Pro-Ana Websites and its Impact on the Quality of Life of Anorexic Patients

Fernanda Bastos, MA; PhD, University of Lisbon, Lisbon, Lisbon, Daniel Sampaio, PhD, University of Lisbon, Lisbon, Lisbon, Ana Vaz, PhD, University of Minho, Braga, Braga

Pro-anorexia (pro-ana) websites have been growing in number and popularity. These websites promote anorexia nervosa as a lifestyle rather than a disease. Consequently, it tends to negatively affect the quality of life of visitors. Aiming to better understand the associations between pro-anorexia website usage and the quality of life of anorexic patients, the goal of this study was to identify a path of influence between pro-ana website usage and the quality of life of visitors. Hence, this study proposed the following model (Pro-Ana Website Usage → Dietary Restraint → Body Dissatisfaction → Self-Esteem → Quality of Life). Another goal of this study was to compare patients who visit pro-ana websites to patients who do not visit it, regarding different psychological variables as quality of life, eating disordered behaviors, body dissatisfaction, psychosocial impairment and self-esteem. Fifty Portuguese female anorexic patients participated in this study. In order to collect data, it was used a demographic and clinical questionnaire and 5 other scales (WHOQOL-BREF, RSES, BSQ, CIA and EDE-Q). Our results showed that the use of pro-ana websites is related to higher levels of body dissatisfaction, psychosocial impairment and eating disordered behaviors, and to lower levels of quality of life. Furthermore, the hypothesized model was supported by our findings, which shows that the use of pro-ana websites is positively associated with dietary restraint, which is positively associated with body dissatisfaction, which in turn is negatively associated with self-esteem, which is positively associated with quality of life. Perhaps, the most significant contribution of this study is the proposition of a new significant model that shows a path of influence that helps us to understand the negative effect related to the use of these websites.

F112: On the Ground: Translating Eating Disorder Training into Practice: A 4 Month National Evaluation of Clinician Experience in Enacting FBT and CBT in the Irish National Clinical Programme for Eating Disorders: Reflection, Barriers, and Opportunities

Sara McDevitt, MB; MD; MEd; MRCPsych, Health Service Executive, Ireland, University College Cork, Cork, Co. Cork, Aileen Whyte, BA; MA; PhD, Health Service Executive, Cork, Cork, Rhona Jennings, BSc; MBA, Health Service Executive, Dublin, Ireland

The purpose of this study was to evaluate the effectiveness of two national training initiatives for FBT and CBT- E which were rolled out to clinicians working in adult and child community mental health services across Ireland in 2014 /2015. The subject sample included a clinician from each of the community mental health teams across the country. In total, 72 clinicians participated in the FBT training, and 62 in the CBT- E, each from a single team. Each clinician completed a pre -training baseline questionnaire regarding their prior eating disorder (ED) experience, attitudes, caseload, and demographics etc. After the 2 day training, they completed a further evaluation questionnaire, and at 4 months, a follow up questionnaire including quantitative and qualitative sections including perceived fidelity was sent. 51 (70.8%) and 33 (53.2%) responded to the FBT and the CBT- E follow up surveys respectively. For FBT, 34 (66%) had commenced or switched patients to FBT at 4 months, with 29 (56.8%) having updated care plans. 36 (70%) had shared the information with coworkers. However, though confidence increased, fidelity to the models were variable with only 19 (41.3%) always completing the family meal. For CBT- E, 20 (62.5%) were achieving real time recording in all cases, with 25 (78%) introducing regular eating in all cases. Participants indicated that barriers to translation into clinical practice included inadequate caseload referrals (1/3), other clinical demands (27.9), comorbidity (36.9%) and lack of dedicated time. Significant protective factors included being named as having an ED role on their community team, being part of an ED hub and supervision. The findings support the view that single clinicians in generic mental health services will encounter significantly more barriers to deliver on their ED training compared with those in specialist ED services.

F113: Interaction Between Orexin-A and Sleep Quality in Females in Extreme Weight Conditions

Sarah Sauchelli Toran, BSc; MSc, Department of Psychiatry, University Hospital of Bellvitge-Idibell; Ciberobn, Barcelona, Spain, Susana Jiménez-Murcia, PhD, Department of Psychiatry, University Hospital of Bellvitge- Idibell; Ciberobn, Barcelona, Spain, Francisco J Tinahones, PhD, Hospital Clínico Universitario Virgen de Victoria, Málaga, Provincia de Málaga, Felipe F Casanueva, PhD, Santiago de Compostela University, Complejo Hospitalario Universitario, Santiago de Compostela, La Corunya, Cristina Botella, PhD, University Jaume I, Castellón, Provincia de Castellón, Rafael de la Torre, PhD, IMIM-Hospital del Mar Research Institute, Parc de Salut Mar, Barcelona, Spain, Jose M Fernández-Real, PhD, d’Investigació, Biomèdica de Girona (IdIBGi), Hospital Dr Josep Trueta, Gerona, Provincia de Gerona, Gema Frühbeck, PhD, University of Navarra-IdiSNA, Pamplona, Provincia de Navarra, Roser Granero, PhD, Autonomous University of Barcelona, Barcelona, Provincia de Barcelona, Stephan Zipfel, MD; PhD, University of Tübingen, Tübingen, Baden-Wurtemberg, Katrin E Giel, PhD, University of Tübingen, Tübingen, Baden-Wurtemberg, José M Menchón, MD, University Hospital of Bellvitge- Idibell, Barcelona, Spain, Fernando Fernández-Aranda, PhD, University Hospital of Bellvitge- Idibell; Ciberobn, Barcelona, Spain

Objectives: Due to the increasing prevalence of obesity, understanding its underlying mechanisms is a pressing issue. The current study aimed to explore how an interaction between orexin-A and sleep quality might be related to weight status (from healthy weight to morbid obesity). Method: Plasma orexin-A concentrations and sleep were evaluated in 26 obese, 40 morbid obese and 32 lean control participants in a case-control design. The sleep monitor Actiwatch 7 and the Pittsburgh Sleep Quality Index were used to evaluate sleep. In addition, depression, anxiety and somatization symptoms were evaluated with the Symptom Checklist-90 Revised. Results: A higher weight status was associated with elevated plasma orexin-A concentrations (p = .050), as well as greater anxiety (p < .001), depression (p < .001) and somatization symptoms (p < .001). Both obese and morbid obese groups reported poorer sleep quality compared to the control group (both: p < .001) and a quadratic trend was found in objective sleep time, being of longer duration in the obese group (p = .031). Structural equation modeling showed plasma orexin-A to be related to poor total sleep quality, which in turn was associated with elevated body mass index. Conclusions: Our data therefore confirms a complex relationship between orexin-A, sleep and obesity. The significant interaction between altered plasma orexin-A concentrations and poor sleep quality contributes to fluctuations in body mass index. This should be taken under consideration when tackling the problem of obesity.

F114: Mediators of the Relationship between Perceived Discrimination and Disordered Eating in Bariatric Surgery Patients

Aliza Friedman, MA; PhD Student, Department of Psychology, Ryerson University, Toronto, Ontario, Susan Wnuk, PhD, Toronto Western Hospital, Bariatric Surgery Program, Toronto, Ontario, Sanjeev Sockalingam, MD, Toronto Western Hospital, Bariatric Surgery Program, Toronto, Ontario, Stephanie Cassin, PhD, Department of Psychology, Ryerson University, Toronto, Ontario

The association between perceived discrimination and disordered eating in overweight and obese populations has garnered a great deal of recent research attention; however, there remains a dearth of research examining the specific mechanisms underlying these associations. The purpose of this study was to examine psychological distress mechanisms (body shape concerns, general psychological distress) as potential mediators in the relations between perceived discrimination and disordered eating (binge eating and emotional eating) in pre-operative bariatric surgery patients. Adult bariatric surgery patients (N = 103, Mage = 42.32, MBMI = 49.31 kg/m2) completed a series of questionnaires assessing perceived discrimination, psychological distress, body shape concerns, binge eating, and emotional eating (eating in response to anger/frustration, anxiety, and depression) as part of an ongoing research study at the Toronto Western Hospital, Bariatric Surgery Program. Results revealed that bariatric surgery patients who reported perceiving discrimination on the basis of their weight/shape were at an elevated risk for both binge eating and emotional eating in response to anger/frustration and anxiety; however, the association between perceived discrimination and emotional eating in response to depression was nonsignificant. Using nonparametric bootstrapping analyses, body shape concerns emerged as a significant mediator in the relation between perceived discrimination and all three facets of emotional eating (anger/frustration, anxiety, and depression); however, a suppression effect emerged in the relation between perceived discrimination and binge eating. These results highlight body shape concerns as the most relevant explanatory mechanism in the relation between perceived discrimination and emotional eating, suggesting that improving body shape concerns may help to reduce emotional eating among pre-operative bariatric surgery patients.

F115: Cholesterol, Homocysteine and Suicidal Ideations in Female Patients with Anorexia Nervosa

Andres Gomez del Barrio, DClinPsy, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Elsa Rodriguez, Student, San Juan Bautista School of Medicine, Puerto Rico, Puerto Rico, Jana Gonzalez, DClinPsy, Hospital Universitario Marques de Valdecilla, Santander, Cantabria, Ines Madrazo, DClinPsy, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Ruth Landera, DPsych, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Laura Carral, DPsych, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Pilar Benito, DClinPsy, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Gabriel Calcedo, DClinPsy, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria

Hypothesis: In a group of patients diagnosed with anorexia nervosa, there is a relationship between analytical parameters, especially in those of cholesterol, suicidal ideations, and impulsive conduct. Forty-five patients from Hospital Universitario Marques de Valdecilla's psychiatric eating disorders program (UTCA) were selected in a consecutive manner for this study. Forty-eight control patients were chosen from the community on a voluntary basis. Plasma levels of cholesterol, ions, homocysteine, vitamins and other biochemical parameters were evaluated on admission prior to the initiation of treatment. The impulsivity score of EDI was used to measure impulsive traits of each subject. Suicidal ideation was measured as “item” using a dichotomized BECK scale. Autolytic intentions and auto-lesions were analyzed and coded as 0 for absent and 1 for present. Descriptive, comparative, and correlational analysis were performed. Fourteen patients presented suicidal ideation. Total cholesterol (high) and homocysteine (high) levels were significantly associated with suicidal ideation. The rest of analytical and psychological parameters were normal.Past studies suggest that there could be a relationship between low levels of cholesterol and suicide. Our study shows opposite results: high cholesterol correlated with increased suicidal ideations. In recent investigation (Frieling et al 2008, J Psychiatr Res 42:83–86), self-rated depressive symptoms were significantly associated with elevated homocysteine serum levels in patients with eating disorders. However, in our study, we found an association with suicidal ideations.The difference between our study and the previously published studies is that our study had a control group, whereas the other ones did not. Our study differs from others in that patient and control group blood work was obtained and analyzed in the same week, as the patients filled out questionnaires that measured suicidal ideation, depressive symptomatology, and impulsive conducts.

F116: Body Dissatisfaction, Body Change And Self-Esteem In Adolescent

Georgina Alvarez Rayón, PsyD, Facultad de Estudios Superiores Iztacala, UNAM, México, Mexico, Brenda Sarahi Cervantes Luna, PsyD, Centro Universitario UAEM Ecatepec, UAEM, México, Mexico, María del Consuelo Escoto Ponce de León, PsyD, Centro Universitario UAEM Ecatepec, UAEM, México, Mexico

Adolescents are especially susceptible to internalizing of the body ideals and the development of body dissatisfaction (BD). These conditions have an effect on the adolescents' self-esteem, so that, they could adopting body change strategies (BCS). The purposes of this study were: 1) evaluate if women and men differ in the directionality of body dissatisfaction and body change behavior (pro-thinness vs. pro-muscularity); 2) explore whether there is a differential association between aspects related to thinness and muscularity in women and men; y 3) explore whether the association of these variables (BD and BCS) with self-esteem differs, or not, between males and females. Method. It is a study with a non-experimental cross-sectional research design. The sample consisted of 285 adolescents of both sexes, and their age ranged between 11 and 16 years. Results. Women showed a higher degree of pro-thinness BD than men, but we did not find differences in pro-muscularity body dissatisfaction between both sexes. Contrary to this, the drive to increase muscularity was higher in men. With regard to BCS, women scored higher on those aimed at thinness and men on those aimed at increased muscle mass. Both men and women, pro-thinness BD was related with higher pro-muscularity BD and BCS; nevertheless, we identified other association patterns differentiated by sex. Finally, in women and men, the self-esteem negatively correlated with the variables relating to thinness or muscularity; these correlation coefficients were greater in men. Conclusions. The results are discussed in light of the transformations of body ideals over time, emphasizing on the changes during the last decade. This work was partially funded by UNAM PAPIIT-IN306615.

F117: Self-Compassion and Drive for Muscularity: An Examination of Gender and Self-Compassion as Predictors of Drive for Muscularity

Rachel Kramer, BA; MA, University of North Dakota, Grand Forks, North Dakota, Nicole M. Della Longa, BS; MA, University of North Dakota, Grand Forks, North Dakota, Taylor Perry, Student, University of North Dakota, Grand Forks, North Dakota, F. Richard Ferraro, PhD, University of North Dakota, Grand Forks, North Dakota

Self-compassion (SC) is defined by three factors: self-kindness, mindfulness, and common humanity (the ability to perceive one’s flaws or distress as universally experienced). Prior research suggests that SC negatively relates to body dissatisfaction. For instance, SC has been noted to moderate the relationship between thin ideal internalization and weight concern and between BMI and disordered eating. This study aimed to further evaluate the protective merits of SC on drive for muscularity. It was hypothesized that higher levels of SC would predict lower levels of drive for muscularity. Exploratory analyses were also conducted to examine whether SC would predict drive for muscularity differently among men and women. Participants, who were undergraduate men (n = 49) and women (n = 216) from a Midwestern university, completed a battery of measures. Multiple regression analyses were used to evaluate the aims of the study, including the exploratory analyses. In order to evaluate whether SC predicts drive for muscularity differently among males and females, interaction effects were assessed. At Step 1, gender was entered, at Step 2, SC was entered, and at Step 3, the interaction between gender and SC was entered. SC was a significant predictor of drive for muscularity as hypothesized (p < .001). Additionally, all steps of the model were significant and explained 21.7% of the variance in drive for muscularity (p < .001). After controlling for gender and SC, there was a significant interaction among gender and SC (p < .01). Males and females who reported higher levels of SC endorsed similarly lower levels of drive for muscularity. However, males who reported lower levels of SC reported significantly higher levels of drive for muscularity than women who reported lower SC. This interaction suggests that SC predicts drive for muscularity differently among women and men. SC appears to be an important trait to continue to evaluate, as it may be a protective factor against drive for muscularity, especially among males.

F118: Drunkorexia Prevalence in a College Sample and Associations with Eating Disturbance

Emily Choquette, BA; Student, University of South Florida, Tampa, Florida, J. Kevin Thompson, PhD, University of South Florida, Tampa, Florida

"Drunkorexia” is a term that is used to describe a range of behaviors designed to increase the intoxicating effects of alcohol consumption through food restriction or negate the caloric gain from alcohol consumption by restriction and/or purging. The current study looked at gender differences in prevalence and associations with eating disturbance, using Thompson and colleagues Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale (CEBRACS). The sample was 852 participants (193 males, 658 females) from a large Southeastern university, mean (SD) age = 20.7 (4.23), mean (SD) BMI = 24.19(5.34). There were no gender differences on the CEBRACS total score. Among the four subscales of the CEBRACS, there was only one significant gender difference - women reported higher scores on the “restriction in relation to alcohol” subscale (M = 2.29, SD .98) than men (M = 2.17, SD .59), t (524.55) = 2.02, p = .04. For women the CEBRACS total score was correlated with drive for thinness (r = .35, p <.001) and eating disorder symptoms (r = .40, p <.001). Men’s CEBRACS score was not significantly correlated with drive for thinness; however, it was correlated with eating disorder symptoms (r = .33, p <.001). This is the first large scale prevalence study of drunkorexia. Evidence of significant associations with eating disturbance suggest the phenomenon may be a risk factor with clinical implications.

F119: Multivariate Analyses of DTI, fMRI, and Questionnaire Data Significantly Distinguish Anorexia Nervosa from Body Dysmorphic Order

Don Vaughn, BA; BS, UCLA, Los Angeles, California, Teena Moody, PhD, UCLA, Los Angeles, California, Gigi Cheng, Student, UCLA, Los Angeles, California, Aifeng Zhang, PhD, University of Illinois at Chicago, Chicago, Illinois, Alex Leow, PhD, University of Illinois at Chicago, Chicago, Illinois, Michael Strober, PhD, UCLA, Los Angeles, California, Jamie Feusner, MD, UCLA, Los Angeles, California

Anorexia nervosa (AN) and body dysmorphic disorder (BDD) share distorted perception of appearance, obsessive and compulsive tendencies, and poor insight, and are frequently comorbid with each other. In some cases, correctly distinguishing AN from BDD can prove difficult. This may be of particular clinical relevance in early stages of the illness. To aid in diagnosis, we here used neuroimaging and questionnaire data to predict diagnoses for eighty four medication-free, normal-weight participants (twenty four with DSM-IV AN, twenty nine with DSM-IV BDD, and thirty one healthy controls (CTL)). The multi-modal data consists of blood oxygen level-dependent signal changes (BOLD) from task-based functional magnetic resonance imaging (fMRI) using face, body, and house visual stimuli; pathlength metrics from diffusor tensor imaging (DTI); and responses from the BDD Yale-Brown Obsessive Compulsive Scale (YBOCS) or Yale-Brown-Cornell Eating disorder scale (YBC), and Brown Assessment of Beliefs Scale (BABS). The fMRI data was averaged by regions, according to the Glasser 2016 Human Connectome Project 1.0 parcellation, and then decomposed into fewer features using independent components analysis. Randomly selecting equal numbers of participants from each group, a two-class support vector machine correctly distinguished AN vs BDD participants with an accuracy of 70% [66,73] (p<.001). Controlling for multiple comparisons, the top 3 independent components from the fMRI task data and the normalized mean pathlength from the DTI results were the most significant features in making the prediction. Because classification accuracy is significantly reduced using the questionnaire data alone, we suggest that the fMRI and DTI data contain unique information in distinguishing AN and BDD.

F120: Environmental Correlates of Patients with Eating Disorders: An Exploratory Chart Review

Jennifer Henretty, PhD, Center For Discovery, Los Alamitos, California, Shelbi Cox, BS, Center For Discovery, Los Alamitos, California

The evidence pointing toward hereditary causes of eating disorders is irrefutable; however, twin studies suggest that environmental factors are also likely at play. Identifying environmental correlates of eating disorders could allow for more effective risk assessment and prevention efforts. Comparing chart review data from approximately 2500 patients who received treatment in an IOP, PHP, or RTC setting for eating disorders to census and other forms of government-collected data when applicable, this exploratory study was able to identify correlates that may warrant further examination. Results suggest that type of parental occupation, among other correlates, may be relevant for early identification of youth at risk for eating disorders.

F121: Evaluation of a Day-Hospital Program Following an Inpatient Stay for Teens with Eating Disorders: Adolescents’, Parents’, Clinicians’ and Administrators’ Perspectives

Marie-Claude Fortin, PhD, Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Louis Picard, PhD, Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Danielle Taddeo, MD, Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Nadeau Pierre-Olivier, MD, Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Olivier Jamoulle, MD, Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Valérie Simard, M.Ps., Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Chantal Stheneur, MD; PhD, Centre Hospitalier Universitaire Sainte-Justine, Montrésl, Québec

Despite methodological difficulties, literature shows positive effects of day-hospital programs (DHP) on teens with eating disorders. As we started our own DHP, we conducted a study to (1) evaluate adolescents and parents’ opinions concerning the contribution of DHP in the treatment, (2) compile clinicians’ views about the integration of DHP to the existing hospitalisation program (HP), and (3) compare costs and benefits between DHP and HP. Adolescents and one of their parents were asked to complete a self-administered anonymous questionnaire on their first day of DHP and at discharge. The survey included: motivation, perception of physical and mental health, stress concerning health, willingness to change, goals, satisfaction, perceived impacts of the treatment, family and social relationships, and mood. Clinical team members were asked to give their opinion about relevance, coherence, efficacy, and interdisciplinary collaboration. Administrators compared daily financial costs of treatment with HP only or HP then DHP. Adolescents perceived principally a better occupation of free time with reduction of excessive exercise and an improvement in family conflicts. Parents reported better mood in their adolescent, better quality of family life and a decrease in parental stress. In fact, parents perceived themselves as more ready to help their teen than teens to quit the reassuring environment of the inpatient unit. Team members reported that DHP upgraded services to families and increased the efficacy of interdisciplinary work. They also suggested offering more in vivo normalizing experiences during treatment. As expected, replacing HP by DHP after health rehabilitation in HP was cost effective. This 360-degrees study demonstrates that DHP is relevant as it supports transition to outpatient services. Future research must include standardized measures to help understand how DHP promotes change and motivation in teens with ED compared to outpatient and inpatient experiences.

F122: Outpatient Treatment for Adolescents with Anorexia Nervosa : Predictors of 12 Month BMI Trajectories

John Hodsoll, PhD, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK, Janet Treasure, MRCPsych; FAED, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK, Charlotte Rhind, PhD, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK, Nadia Micali, PhD, Institute of Child Health, University College London, London, UK, Jon Arcelus, PhD, University of Nottingham, Nottingham, East Midlands, Ulrike Schmidt, PhD, Institute of Psychiatry, Psychology and Neuroscience, London, UK, Sabine Landau, PhD, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK

The aim of this study was to examine the predictors of 12 month BMI trajectories in a multicentre study of outpatients with anorexia nervosa. Data were collected at monthly intervals during the ECHO randomised controlled trial (N=149) with the addition/or not of an intervention in the first 6 months to improve carer skills. We used longitudinal non-parametric k-means cluster analysis to identify potential classes of 12 month trajectories in BMI. Key baseline predictors of cluster membership were then investigated. Participants were only included if they had at least 2 observations (N = 143). A 3 cluster solution was chosen as the best partition quality according to Calinski & Harabasz criterion, clinical interest and minimal group size of 10% of total sample. In the first cluster, participants (N = 27, mean baseline BMI = 19.6) showed a pronounced 2 point increase in BMI over the first 2 months, rising to 22.1 by end of treatment (6 months) and maintained at 12 months follow-up. For the second group [N = 85 (59%), mean baseline BMI = 16.9] there was a slower 1.4 increase in BMI by 6 months, rising to 18.7 at 12 months. In the third group, [N = 31 (21.7%), baseline BMI =15.2) showed little change in BMI over 6 months (0.08) and 12 month follow-up (15.8). Using logistic regression, being in a responder group (1 or 2) vs non-response (3) was associated with shorter duration of illness (OR: 0.71, 95%CI: 0.51, 0.96) and higher lowest-ever BMI (OR: 2.2, 95% CI: 1.41, 3.37). Carer treatment group was not associated with clusters. The effectiveness of outpatient therapy may be limited for patients of low weight and / or extended illness duration.

F123: The Influence of Negative Affectivity/Impulsivity and the Serotonin Transporter Gene on Emotional Eating and Weight

Tara Ohrt, BA, Arizona State University, Tempe, Arizona, Marisol Perez, PhD, Arizona State University, Tempe, Arizona, Jeffrey Liew, PhD, Texas A&M University, College Station, Texas

Childhood obesity is a major public health concern associated with many health risks as well as high annual public health costs. Emotional eating has been identified as a risk factor for overweight status among children though very little is known about what predisposes children to emotionally eat. The human serotonin transporter gene (5-HTTLPR) is a promising candidate gene to help explain individual differences in emotional eating and weight status which may be moderated by temperament. Therefore, the proposed model explored the relationship between genetic susceptibility (the interaction between 5-HTTLPR and temperament) and weight status mediated by emotional eating. To test this model, 147 children ranging in age from 4- to 6-years old, along with their primary caregiver, completed a number of tasks and questionnaires in order to assess the child’s genetic make-up, temperament, emotional eating (rate of total caloric intake), and weight status (percent body fat). The mediation aspect of this model was not supported. However, findings suggested the association between child temperament with emotional eating and percent body fat differed by genotype. For most analyses, children with the SS variant had the lowest weight and rates of emotional eating across impulsivity and negative affect, children with the LL variant had the highest, and children with the SL variant were the least impacted. Results from this study suggest a potential differential susceptibility to childhood obesity. These findings have strong implications for universal prevention programs for childhood obesity.

F124: Gender Differences in Body Image, Dietary Habit and Metabolic Profile in a Group of Overweight Subjects

Emilia Manzato, MD, psychiatrist, University of Ferrara, SISDCA, Ferrara, APO AE, ferrara, Veronica Grifoni, Student, dietitian, University of Ferrara, Ferrara, APO AE, ferrara, Roberta Mungari, MD, Section of Endocrinology University of Ferrara, Ferrara, APO AE, ferrara, Mariella Celico, MD, Section of Endocrinology, University of Ferrara, Ferrara, APO AE, ferrara, Maria Rosaria Ambrosio, MD, Section of Endocrinology, University of Ferrara, Ferrara, APO AE, Ferrara

The aim of our study is to evaluate the presence of gender differences concerning image perception, dietary attitude and metabolic profile in a group of 19 overweight people (10 women and 9 men) referred to Endocrinology clinics. We used psychological tests (Beck's Depression Inventory, Body Uneasiness Test, Eating Attitude Test-26, Binge Eating Scale), dietary surveys and metabolic parameters (oral glucose tolerance test and lipid profile). Results show that only 44,4% of men against 90% of women consider themselves overweight; otherwise only 22,2% of men against 60% of women weigh themselves once a week. 33,3% of men and 60% of women have objective binge eating episodes and this is associated with a higher Body Mass Index, whereas 33,3% of men and 70% of women have subject binge eating. Women have higher scores than men in psychological tests; this difference is statistically significant (p<0,02) in two scale: Eating Attitude Test-26 (28,06 vs 27,17) and Body Image Concern (16,8 vs 6,67) of Body Uneasiness Test. Three subjects are positive to Binge Eating Scale and Beck's Depression Inventory. Women have a worse lipidic profile than men (LDL cholesterol: 142,1±47,8 vs 119,2±29,9) Our study suggests the presence of gender differences in overweight patients in terms of image perception, dietary attitude and metabolic profile and confirms the importance of a multidisciplinary approach to overweight and obesity.

F125: Body Image and Weight Gain During Pregnancy

Emilia Manzato, PhD, Psychiatrist, University of Ferrara, Ferrara, APO AE, Ferrara, Giada Gregoratti, Student, dietitian, Ferrara, APO AE, Ferrara, Eleonora Roncarati, dietitian, Private Hospital " Salus" ferrara, Ferrara, APO AE, Ferrara

Pregnancy induces deep and quick changes in female body and in psychological functions: is an interesting moment to study the changes in body image and weight (Body Mass Index). The aim of our study is to investigate some possible correlations between body image and BMI before pregnancy and weight gain during pregnancy. 33 women in the last three months of pregnancy were recruited in two pubblic hospitals (Ferrara and Udine). A structured interview and some tests (such as Eating Disorders Inventory and Body Uneasiness Test) were administered. BMI was examinated before pregnancy and during the pregnancy till the childbirth. The body perception before pregnancy has been investigated by means of following question: "how did you see yourself: underweight, normalweight or overweight?"; the answers have been correlated with BMI. The study showed a strong correlation between body image and weight gain: in fact a disturbed body perception before pregnancy is correlated with an altered weight gain during pregnancy. Also the BMI before pregnancy is correlated with weight gain in pregnancy, particularly the most women with an pre gravidic overweight/obese gained more weight during the pregnancy than what suggested by the OMS line guides; furthermore, pre-pregnancy underweight or overweight are correlated with higher body dissatisfaction during pregnancy (high scores in BUT and EDI- subscale Body Dissatisfaction). The study highlights the role of body image and BMI before pregnancy and their influence on weight gain during pregnancy. It also suggests the importance of a multidisciplinary approach to pregnancy and the need to investigate body dispercepition and unhealty weight (underweight, overweight, obesity) prior to pregnancy.

F126: Food Addiction in Behavioral Addictions: Frequency and Clinical Outcomes

Susana Jiménez-Murcia, PhD, University Hospital of Bellvitge-Idibell, Ciberobn, Hospitalet de Llobregat, Barcelona, Susana Jiménez-Murcia, PhD, University Hospital of Bellvitge- Idibell, Ciberobn, Hospitalet de Llobregat, Barcelona, Roser Granero, PhD, Universitat Autònoma de Barcelona, Barcelona, Barcelona, Ines Wolz, PhD, University Hospital of Bellvitge- Idibell, Ciberobn, Hospitalet de Llobregat, Barcelona, Marta Baño, MSc, University Hospital of Bellvitge- Idibell, Hospitalet de Llobregat, Barcelona, Gemma Mestre-Bach, PhD, University Hospital of Bellvitge- Idibell, Ciberobn, Hospitalet de Llobregat, Barcelona, Trevor Steward, MSc, University Hospital of Bellvitge- Idibell, Ciberobn,, Hospitalet de Llobregat, Barcelona, Zaida Agüera, PhD, University Hospital of Bellvitge- Idibell, Ciberobn, Hospitalet de Llobregat, Barcelona, Anke Hinney, PhD, Universitätsklinikum Essen, Essen, Essen, Carlos Dieguez, PhD, University of Santiago de Compostela-Instituto de Investigación Sanitaria, Santiago de Compostela, A Coruña, Felipe F Casanueva, MD; PhD, Complejo Hospitalario Universitario de Santiago de Compostela, Coberobn, Santiago de Compostela, A Coruña, Ashley Gearhardth, PhD, University of MichiganAnn Arbor, Michigan, Anders Hakansson, PhD, Lund University, Lund, Lund

The food addiction (FA) model is receiving increasing interest from the scientific community. Available empirical evidence suggests that this condition may play an important role in the development and course of physical and mental health conditions such as obesity, eating disorders and other addictive behaviors. However, no epidemiological data exist on the comorbidity of FA and gambling disorder (GD), or on the phenotype for the co-occurrence of GD+FA. The main objectives were threefold: to determine the frequency of the comorbid condition GD+FA, to assess whether this comorbidity features a unique clinical profile compared to GD without FA, and to generate predictive models for the presence of FA in a GD sample. Data correspond to 458 treatment-seeking patients who met criteria for GD in a hospital unit specialized in behavioral addictions. Point prevalence for FA diagnosis was 9.2%. A higher ratio of FA was found in women (30.5%) compared to men (6.0%). Lower FA prevalence was associated with older age. Patients with high FA scores were characterized by worse psychological state, and the risk of a FA diagnosis was increased in patients with high scores in the personality traits harm avoidance and self-transcendence, and low scores in cooperativeness. In conclusion, the co-occurrence of FA in treatment-seeking GD patients is related to poorer emotional and psychological states. GD treatment interventions and related behavioral addictions should consider potential associations with problematic eating behavior and aim to include techniques that aid patients in better managing this behavior.

F127: Convergent Validity of the Restructured Version of the Eating Disorder Examination Questionnaire in Japanese Adolescents

Tomoyo Mitsui, PhD, Kobe Shinwa Women's University, Kobe, Hyogo, Toshiyuki Yoshida, MA, International University of Health & WelfareI, Fukuoka, Fukuoka, Gen Komaki, PhD, International University of Health & Welfare, Hukuoka, Fukuoka

This study aims to examine the convergent validity of the Japanese version of Eating Disorder Examination Questionnaire version 6.0 (EDE-QJ) with other eating questionnaire measures, Eating Attitudes Test (EAT-26) and Eating Disorders Inventory-II (EDI-II) for Japanese adolescents. Participants were undergraduate students (N = 558) to examined with EAT-26 and EDE-QJ. Mean age was 20.11 years (SD = 2.52). Additionally, to examined with EDI-II and EDE-QJ, we recruited 111 undergraduate students, the mean age was 18.52 years (SD = 0.77). Participants also provided written consent to participate prior to completing the questionnaire. Pearson’s correlation coefficients were used to evaluate the relation between EDE-QJ scores and scores of EAT-26 and EDI-II. Our previous exploratory factor analysis of the EDE-QJ for university students yielded four significant factors, two of which are different from those of the original questionnaire; “Fear of obesity” and “Influence of weight and shape on self-esteem” are different from “Weight Concern” and “Shape Concern” of the original, whereas “Restriction” and “Eating concern” were the same. The convergent validity of the original and restructured EDE-QJ was examined whether the subscales scores correlate with measures of similar constructs, the EAT-26 and the EDI-II, respectively. Like the original subscales, the restructured EDE-QJ subscales were similarly and moderately correlated with the EAT and EDI-II subscales. The subscales, “Fear of Obesity” and “Self-Esteem based on Shape and Weight” in the restructured EDE-QJ were strong and moderately correlated with the EDI-II subscale of body image such as Drive for Thinness and Body Dissatisfaction. Additional research is required to extend and replicate these findings.

F128: The Positive Impact of Putting Patients’ and Carers’ Perspectives at the Centre of Service Improvement and Development

David Viljoen, MSc, MSS Couns.Psych, Oxford and Buckinghamshire Eating Disorders Service (Cotswold House), Oxford, Oxfordshire, UK, Sharon Ryan, DipHE MH Nursing, Oxford and Buckinghamshire Eating Disorders Service, Oxford, Oxfordshire

The purpose of this presentation is to share experiences of placing patient and carer involvement at the centre of care in a UK adult eating disorders service. Perspectives and undertakings of patients, carers and staff contributed to shared goals of enhancing patient safety, satisfaction and experience. Patients and carers offer unique voices and must work with staff, health care providers, commissioners and regulators to develop services and improve quality. Benefits of patient and carer involvement typically include: Access to unique insights of experts by experience who offer different perspectives to staff; tailoring quality healthcare services according to needs; improved confidence and self-esteem of patients; and better outcomes for patients, carers and staff. Different theoretical models of levels of patient and carer involvement will be described. Examples will be given of various service improvements based on surveys, consultations, collaborations and patient/carer- led projects. Initiatives to improve the inpatient experience included the introduction of preadmission planning meetings to identify shared goals; a pre-admission patient-to-patient information leaflet; patient redesign of the day- and inpatient information booklet and the routine allocation at admission of an outreach nurse for family liaison and support. A carer's forum produced a 'carer-to-carer' admission leaflet and is exploring peer support initiatives for carers. As active stakeholders in service development, patients developed a training video for staff on how (and how not) to best support them in the dining room. Patients presented at a staff away day on how they would 'reimagine eating disorders services' highlighting for example the need to embrace technology in service delivery. Improvements in the experience of psychological therapy included allocation of therapists at admission and the named therapist offering seamless therapy to their patients across out-, day and in patient services. The participants will be encouraged to challenge established organisational cultures where care “is done to people and not with people” and to routinely consider the views of patients and carers for the benefits of all stakeholders.

F129: Attitudes Towards Orthorexia Nervosa Relative to DSM-5 Eating Disorders

Courtney Simpson, MS, Virginia Commonwealth University, Richmond, Virginia, Suzanne Mazzeo, PhD; FAED, Virginia Commonwealth University, Richmond, Virginia

Stigmatization of individuals with clinical eating disorders (EDs) is concerning, as it inhibits treatment seeking and appears to exacerbate symptomatology. A pattern of disordered eating involving a pathological fixation with healthy food consumption, labeled orthorexia nervosa (ON), has recently generated attention; however, research has not investigated perceptions of ON-related behaviors. This study examined potential stigmatization of ON, compared with ED diagnoses included in the DSM-5. Participants (n = 505) were randomly assigned to read a vignette depicting a woman with anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), or ON. Participants then answered questions about the individual depicted in their vignette. A series of MANOVAs investigated whether ED type depicted was related to opinions and beliefs about the target disorder and perceptions of etiological influences. Individuals with BED were considered better able to “pull themselves together" than individuals with ON (p < .05), and individuals with AN and ON were perceived as "harder to talk to" and more of “a danger to others” than individuals with BED (all ps < .01). ON was viewed as less “distressing,” less “likely to evoke sympathy,” and more “desirable” than the other disorders (all ps < .05). “Poor living choices” were perceived as contributing more to ON than to AN, BN, and BED (all ps < .05). Results suggest that ON is viewed as less severe, more desirable, and more often the result personal life choices. Findings from this study imply that ON is associated with stigma, similar to other DSM-5 EDs, and these negative attitudes might reduce the likelihood of treatment-seeking in affected individuals.

F130: Weight Bias: People-First Language in Self-Report Questionnaires

Emilie Lacroix, BA; Student, University of Calgary, Calgary, Alberta, Angela Alberga, BSc; PhD, University of Calgary, Calgary, Alberta, Shelly Russell-Mayhew, BSc; MSc; PhD, University of Calgary, Calgary, Alberta, Lindsay McLaren, BA; MA; PhD, University of Calgary, Calgary, Alberta, Kristin von Ranson, BA; MSc; PhD, University of Calgary, Calgary, Alberta

The purpose of the present systematic review was to examine the use of “people-first” language in self-report questionnaires designed to assess weight bias. Weight bias, defined as negative attitudes about people with overweight or obesity, is pervasive, and is associated with adverse health outcomes. Using stigmatizing language to describe people with obesity may perpetuate weight bias. People-first language respectfully addresses people with chronic disease, rather than labeling them by their illness, and has been affirmed by the American Psychological Association and by the Obesity Society as a standard for publications and programs. Many self-report questionnaires are available to assess weight bias, but it is unclear to what extent these questionnaires employ people-first language. To identify self-report questionnaires that assess weight bias, we searched the electronic databases CINAHL, Embase, Medline, PsycINFO, and Pubmed. For each questionnaire, sample items were coded based on whether they used postmodified nouns (e.g., “people with obesity”) or premodified nouns (e.g., “obese people,” “fat people”) to describe the target of the attitudes being assessed. We identified 40 original self-report weight bias questionnaires. People-first language was exceedingly rare in the items administered to participants: 36 of 40 questionnaires (90.0%) employed premodified nouns in the items administered to participants, with the adjectives “obese,” “overweight,” or “fat” appearing first. Two self-stigma questionnaires (5.0%) referred instead to “my weight,” and the other self-stigma questionnaire employed the phrase “being overweight.” Only a single questionnaire (2.5%) employed postmodified nouns. To uphold current standards, people-first language should be employed wherever possible to convey respect for people with chronic issues such as obesity. We recommend that developers and users of weight bias questionnaires create or modify measures accordingly.

F131: The Application of Flow Theory in the Prevention and Treatment of Anorexia Nervosa

Sara Aslan, BA; MA, The University of Missouri, Kansas City, Kansas City, Missouri, Ashleigh Pona, BS; MA, The University of Missouri, Kansas City, Kansas City, Missouri, Jacob Marszalek, PhD, The University of Missouri, Kansas City, Kansas City, Missouri

The purpose of this study is to utilize Flow Theory as a model to explain the recurring and rewarding behaviors exhibited by individuals suffering from Anorexia Nervosa (AN). The construct being measured is the experience of flow while individuals, who are recovered from and/or active in restrictive behaviors associated with AN, are engaged in the skill of caloric restriction and/or dietary restraint (the objective of restricting their food intake). The target population is females, ages 18 and older, with a current and/or past diagnosis of AN. Restrictive behaviors were conceptualized as a skill explained through the lens of Flow Theory. To accurately measure this skill, the following sub-domains explained by Flow Theory were utilized: challenge-skill balance, action-awareness merging, clear goals, unambiguous feedback, concentration on task at hand, sense of control, loss of self-consciousness, and autotelic experience. Our study measured a typical performance: participants were asked about their experiences during restriction that pertain to Flow Theory. Flow Theory was then used to conceptualize the participant’s motivational states when engaging in restricting behaviors. The findings of this study help to explain that when individuals with AN experience flow (i.e., optimal experience) during restricting, there is an increased chance that they will strive to experience flow in the future, by engaging in disordered eating behaviors. Thus, with elimination of the flow sub-domains, the experience of flow cannot be achieved, and the rewarding feeling of restricting may diminish.

F132: Calorie Counting and Fitness Tracking Technology: Helpful or Harmful?

Courtney Simpson, MS, Virginia Commonwealth University, Richmond, Virginia, Suzanne Mazzeo, PhD; FAED, Virginia Commonwealth University, Richmond, Virginia

The use of online calorie tracking applications and activity monitors is increasing exponentially. Anecdotal reports document the potential for these trackers to trigger, maintain, or exacerbate eating disorder symptomatology. Yet, research has not examined the relation between use of these devices and eating disorder-related attitudes and behaviors. This study explored associations between the use of calorie counting and fitness tracking devices and eating disorder symptomatology. Participants (n=500) were college students (30.0% male, 70.0% female, 51.0% White, 22.6% African American, 18.6% Asian) who reported their use of tracking technology and completed measures of eating disorder symptomatology. Nearly one-fifth (19.6%) of the sample currently used a fitness tracking device, and 13.6% currently used a calorie tracking device. Individuals who reported using calorie trackers manifested higher levels of shape concern, weight concern, eating concern, and dietary restraint, controlling for BMI (all ps<.05). Individuals using a calorie tracking device also reported greater knowledge of healthy eating, more problems associated with healthy eating (e.g., social, occupational, and psychological impairment), and stronger positive feelings related to healthy eating (all ps<.05). Further, individuals who reported using a fitness tracking device exhibited higher levels of shape concern, weight concern, and dietary restraint, when controlling for BMI (all ps<.05). Eating concern did not differ between groups. Individuals using fitness trackers also reported greater knowledge of healthy eating, more problems associated with healthy eating, and stronger positive feelings related to healthy eating (all ps<.05). Findings highlight the positive relation between use of calorie and fitness trackers and eating disorder symptomatology. For some individuals, these devices might do more harm than good.

F133: Exploring Determinants of Disordered Eating Behavior and Eating Disorder Diagnosis through a Developmental Assets Framework

Marilyn Stern, PhD, University of South Florida, Tampa, Florida, Jennifer Bleck, PhD, University of South Florida, Tampa, Florida, Rita DeBate, MPH; PhD, University of South Florida, Tampa, Florida

The Developmental Assets Framework proposes a combination of internal and external assets, which serve as the building blocks to healthy development. Secondary analysis of the National Longitudinal Study of Adolescent Health was employed to assess associations between developmental assets in adolescents and subsequent disordered eating behaviors and diagnosed eating disorders in adulthood. A self-reported positive developmental assets scale was created to assess five external assets including support, encouragement, and bonding with family and neighborhood and five internal assets including self-esteem, sense of purpose, and interpersonal competence. Among females, more self-reported internal assets were associated with lower levels of engagement in disordered eating behaviors (OR: 0.86, 95% CI: 0.82-0.90) and prevalence of diagnosed eating disorders (OR: 0.74, 95% CI: 0.67-0.81). While greater external assets were not associated with disordered eating behaviors, it was associated with increased prevalence of diagnosis (OR: 1.18, 95% CI: 1.06-1.32) among females. No significant associations were observed among males. Results provide additional evidence supporting both internal and external developmental asset based primary prevention and external focused secondary prevention with families.

F134: Associations Between Nonmedical Prescription Stimulant Use for Appetite/Weight-loss Purposes and Eating Disorder Psychopathology

Danielle Beyer, BA, University of North Dakota, Grand Forks, North Dakota, Erica Goodman, BA, University of North Dakota, Grand Forks, North Dakota, Alexandra Thiel, BA, University of Wyoming, Laramie, Wyoming, Taylor Perry, Student, University of North Dakota, Grand Forks, North Dakota, Author, Not Presenting Alison, Looby, PhD, University of Wyoming, Laramie, Wyoming, Author, Not Presenting Kyle, De Young, PhD, University of Wyoming, Laramie, Wyoming

Engagement in nonmedical prescription stimulant use (NPS) for appetite suppression/weight-loss (A/W) is associated with higher levels of eating disorder (ED) psychopathology than NPS solely for cognitive enhancement (CE). This study sought to replicate and extend findings that ED psychopathology is higher in individuals who engage in NPS for A/W compared to NPS for CE, and non-users. Undergraduate participants (N = 451) completed an online survey which included measures of: demographics, lifetime NPS, motives to engage in NPS, Eating Disorder Examination Questionnaire, and the Purgative Behavior Subscale of the Multifactorial Assessment of Eating Disorders Symptoms. A one-way analysis of variance and Tukey HSD tests indicated that individuals who engaged in NPS for A/W reported significantly higher levels of ED pathology than non-users: dietary restraint (F(2, 461)=9.639, p<0.001), eating concern (F(2, 460)=4.565, p=0.008), shape concern (F(2, 461)=9.819, p<0.001), weight concern (F(2, 460)=9.856, p<0.001), and purging pathology (F(3, 463)=11.505, p<.001). Individuals who engaged in NPS for A/W reported significantly more ED pathology than individuals who report NPS for CE: dietary restraint (F(2, 461)=9.639, p=0.032), shape concern (F(2, 461)=9.819, p<0.001), weight concern (F(2, 460)=9.856, p<0.001), and purging pathology (F(3, 463)=11.505, p=.003). These results replicate previous findings that individuals who engage in NPS for A/W have more weight, shape, eating concerns, and purging pathology than those engaging in NPS for CE, and non-users. In a separate comparison, both the NPS for A/W and CE groups engaged in compulsive exercise more frequently than non-users (F(3, 443)=4.780, p=.014; F(3, 443)=4.780, p=.040). These results suggest that there may be a common factor (e.g., personality) that uniquely links NPS and compulsive exercise. Assessing for A/W motives among NPS users may be a useful variable for identifying individuals with ED psychopathology.

F135: Do Individuals with and without Binge Eating Differentially Benefit from Emotion Regulation Strategies used to Buffer the effects of Interpersonal Stress? An Experimental Study

Akanksha Srivastav, MS, Ohio University, Athens, Ohio, Sarah Racine, PhD, Ohio University, Athens, Ohio

Binge eating (BE) is a core symptom of eating disorders that often occurs in response to increases in negative affect. Recent data suggest that negative affect arising from interpersonal stressors is particularly potent at triggering BE. Given that BE is conceptualized as a maladaptive strategy for regulating emotions in individuals who have pre-existing deficits in this domain, training in emotion regulation may help persons susceptible to BE to better manage negative affect from interpersonal stress, thereby reducing their vulnerability to BE. The current study examined whether use of emotion regulation strategies (i.e., cognitive reappraisal versus expressive suppression) while being ostracized via Cyberball differentially impacts subsequent emotions and eating behaviors during a taste test. Females with BE (n = 25) and without BE (n = 23) have been recruited; additional data are being collected. The interaction between group and emotion regulation strategy in predicting positive affect levels post-cyberball was significant, indicating that the mood state of the two groups was differentially impacted by the emotion regulation strategies. Despite non-significant differences in baseline positive affect, BE participants using suppression endorsed significantly lower levels of positive affect compared to control participants using suppression (p = .03). There were no significant differences between positive affect levels for use of reappraisal by BE participants and control participants. Other results trending towards significance included group differences, such that BE participants had higher levels of negative mood post-Cyberball as well as greater liking for food and greater loss of control during the taste test, compared to control participants (ps =.05-.08). Findings extend previous research on the interpersonal model of BE and suggest that cognitive reappraisal may be effective at maintaining positive interpersonal affect and managing BE symptoms.

F136: Linking Purging Pathology and Suicidal Ideation: The Role of Perceived Burdensomeness

Alexandra Thiel, BA; MA, University of Wyoming, Laramie, Wyoming, Danielle Beyer, BA, University of North Dakota, Grand Forks, North Dakota, Nicole Della Longa, MA, University of North Dakota, Grand Forks, North Dakota, Kyle De Young, PhD, University of Wyoming, Laramie, Wyoming

Eating disorders (ED) are associated with high mortality rates from suicide. In particular, purging-type EDs are associated with an increased risk for suicide compared to non-purging-type EDs. The interpersonal-psychological theory on suicidal behavior proposes that active suicidal ideation is formed when an individual experiences high perceived burdensomeness, high thwarted belongingness, and hopelessness. Therefore, this study used a multiple mediation analysis to test the hypothesis that perceived burdensomeness, thwarted belongingness, and hopelessness would mediate the relationship between purging pathology and suicidal ideation in an undergraduate sample (N = 451; 73.7% female) when controlling for past suicidality, current depressive symptoms, current ED symptom severity, and negative urgency. Participants completed online self-report measures on a single occasion. Results indicated a significant indirect effect (95% CI [.02, .06], p < .001) for perceived burdensomeness, suggesting that perceived burdensomeness may be a mechanism that accounts for the relationship between purging pathology and suicidal ideation. Thus, engaging in purging behaviors and/or holding positive attitudes toward purging may lead to suicidal ideation by causing individuals to perceive themselves to be a burden on their friends and family members. Clinically, these results suggest that when determining risk for suicide among individuals endorsing purging pathology, assessing for perceptions of burdensomeness may be a particularly useful variable. Future empirical directions include rigorous testing using longitudinal designs and the more specific operationalization of perceived burdensomeness for individuals with eating psychopathology.

F137: Confirmatory Factor Analysis of the Eating Disorder Examination - Questionnaire (EDE-Q) Among Male University Students in Argentina

Emilio J. Compte, BS; MSc; PhD, Universidad Favaloro, Buenos Aires, Ciudad de Buenos Aires, Ana R. Sepulveda, BS; PhD, Autonomous University of Madrid, Madrid, Comunidad Autónoma de Madrid, Mª Yolanda de Pellegrín Llorente, BSc; MSc,Universidad Complutense de Madrid, Madrid, Comunidad Autónoma de Madrid

The Eating Disorder Examination Questionnaire (EDE-Q) is a self-report questionnaire for assessing the key features of an eating disorder based on a clinical interview whose factor structure requires further investigation among males. This study aims to evaluate the original factor structure and to establish normative data for the EDE-Q among university male students in Argentina. To assess the proposed 4-factor structure, a Confirmatory Factor Analysis (CFA) was performed on 464 students. The internal consistency and convergent validity, using a male-oriented tool (Male Body Attitudes Scale; MBAS), were also assessed. CFA analyses resulted in good fit indixes. Satisfactory levels of internal consistency were obtained (Cronbach’s α .70 to .93). Strong correlations with the MBAS are presented as evidence of convergent validity. The data for males replicated the original factor structure of the EDE-Q and the calculated rank allows to assess more adequately EDs in Argentinean males.

F138: Experiential Avoidance, Eating Expectancies, and Binge Eating in University Students: A Preliminary Test of an Adaption of the AP Model of Eating Disorder Risk

Nicole M. Della Longa, BS; MA, University of North Dakota, Grand Forks, North Dakota, Rachel Kramer, BA: MA,University of North Dakota, Grand Forks, North Dakota, Alexandra Thiel, BA; MA, University of Wyoming, Laramie, Wyoming, Kyle P. De Young, BA; BS; MA; LP; PhD, University of Wyoming, Laramie, Wyoming, Juan Manuel Mancilla Díaz, PsyD, Facultad de Estudios Superiores Iztacala, UNAM, Mexico, Mexico

The present study 1) investigated a potential mechanism through which maladaptive avoidant strategies relate to binge eating and 2) examined experiential avoidance as another factor in the Acquired Preparedness (AP) model of eating disorder risk, which posits that individuals with negative urgency are likely to binge eat due to their belief that eating will alleviate negative emotions. Undergraduate men and women (N = 244) completed questionnaires online, measuring experiential avoidance, negative affect eating expectancies, negative urgency, and binge eating. Bootstrapping mediation analyses and structural equation modeling 1) tested the hypothesis that negative affect eating expectancies mediate the relationship between experiential avoidance and binge eating and 2) examined whether experiential avoidance is a unique predictor of binge eating within the AP model of eating disorder risk. Results revealed a significant indirect effect of experiential avoidance on binge eating (95% CI = [.167, .333], p < .001) with negative affect eating expectancies as a partial mediator. Examining experiential avoidance within the AP model of eating disorder risk again revealed an indirect effect of experiential avoidance on binge eating (95% CI = [.155, .320], p = .001) through negative affect eating expectancies. In this combined model, negative urgency was not associated with negative affect eating expectancies (p = .151) or binge eating (p = .175). These findings demonstrate that experientially avoidant students are at risk for binge eating at least partly due to their expectation that eating will diminish negative affect. Not only is experiential avoidance a unique predictor of binge eating in the AP model of eating disorder risk, but it also may represent a more adequate predictor of binge eating than negative urgency. These findings require replication in longitudinal designs and may further our understanding of the most pertinent dispositional influences of binge eating.

F139: A Double-Blind Randomized Trial of Omega-3 Fatty Acid Supplementation for Treatment of Anxiety in Adolescents with Eating Disorders

Brittny Manos, BA, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, Terrill Bravender, MD, The University of Michigan, Ann Arbor, Michigan, Hannah Lange, MPH, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, Casey Cottrill, MD; MPH, Nationwide Children's Hospital, Columbus, Ohio, Andrea Bonny, MD, Nationwide Children's Hospital, Columbus, Ohio

The objective of this study was to evaluate the association between omega-3 polyunsaturated fatty acid (PUFA) supplementation and trait anxiety among adolescent females with restrictive eating disorders. Adolescents were recruited from the Nationwide Children’s Hospital Partial Hospitalization Program from 1/2015-2/2016. Subjects received standard clinical care and were randomized to 4 daily PUFA (1200mg eicosapentaenoic acid/600mg docosohexaenoic acid) or placebo capsules for 12 weeks. The main outcome variable was trait anxiety, assessed by The Beck Anxiety Inventory-Trait (BAIT) at baseline, 6, and 12 weeks. Secondary outcomes included the Center for Epidemiologic Studies Depression Scale (CES-D), the Eating Attitudes Test (EAT-26), and Medication Tolerability (a 9-item questionnaire addressing frequency of potential side effects). Linear mixed models evaluated associations between randomization group and study outcomes. Of the 24 subjects enrolled (mean age 14.7±1.51; 92% White/Non-Hispanic), 22 and 18 completed 6 and 12 weeks of data collection respectively. Randomization group was not associated with significant differences in BMI (p=.37), medication tolerability (p=.29), CES-D scores (p=.47), or EAT-26 scores (p=.83). Randomization group was significantly associated with trait anxiety (p=.04). All subjects had lower BAIT scores at 12 weeks compared to baseline. Although the rate of change did not differ between groups, the placebo group had significantly lower BAIT scores at 6 and 12 weeks (6-week p-value = 0.01; 12-week p-value = 0.04). BAIT least squares means by group were as follows: baseline PUFA 24.9 ± 3.01 vs. Placebo 22.3 ± 3.09; 6 weeks PUFA 21.2 ± 2.74 vs. Placebo 10.1 ± 3.16; 12 weeks PUFA 14.8 ± 3.14 vs. Placebo 4.8 ± 3.71. PUFA supplementation resulted in diminished improvement in trait anxiety over the course of treatment. Our data do not support a role for PUFA in the treatment of anxiety in adolescents with restrictive eating disorders.

F140: A Change in Attitude towards Life after Interactions with a Medical Clown during Eating Disorders /Hospitalization

Shikma Keller, MD, Hadassah Hebrew University Medical center, Jerusalem, Israel, Sofia Laufer Ben Ari, MD, Hadassah Hebrew University Madical Center, Jerusalem, Israel, Karen Racket, MPH; RD, Hadassah Hebrew University Medical Center, Jerusalem, Israel, Talia Safra, MA, Hakibutzim Seminar Collage, Tel-Aviv, Israel, Adi Lavi, RN, Hadassah Hebrew University Madical Center, Jerusalem, Israel, Yael Noy-Cohen, RN, Hadassah Hebrew University Madical Center, Jerusalem, Israel, Laura Canetti, PhD, Hadassah Hebrew University Madical Center, Jerusalem, Israel, Inbar Sharav-Ifergan, MA, Hadassah Hebrew University Medical Center, Jerusalem, Israel

Medical clowning was developed to ease the suffering of children in hospital.It has become an accepted therapeutic figure in many non psychiatric hospital departments. However, the potential role of a medical clown in the field of eating disorders (ED), has not been evaluated yet. We present a part of our ongoing research in evaluating the benefits of integrating a medical clown into the multidisciplinary team of our adult ED inpatient unit. Anorexia Nervosa patient tend to starve themselves to death. However, studies that examined attitudes towards life and death show increased tendency to reject life rather than be attracted to death. This tendency for rejection of life indicates self guilt. Guilt of promoting her self interests, guilt for existing, eating and enjoying life. The clown is a figure that allows himself to be ridiculous, and not ashamed of expressing his needs and joy. The interaction of ED patients with such a figure can be powerful. The Multiattitude Suicidal Tendency Scale (MASS) provides independent scores of attraction and repulsion to life/death. The purpose of this pilot study was to explore whether a regular interactions with a medical clown during hospitalization can reduce anxiety and depression and influence the attitude toward life and death. Patients hospitalized in our ED unit were administered the Depression, anxiety and stress scale (DASS),The State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), and MASS at the beginning of hospitalization and 8 weeks later. While the control group received treatment as usual, the study group received meal supervision and post meal interventions with a medical clown twice a week for eight weeks. We present preliminary results that might suggest a trend toward reduction in the DASS anxiety scale, an increase in attraction to life and rejection of death in patients exposed to medical clown, compared to patients who did not. These results will be followed in the forthcoming research.

F141: Body Talk: A Qualitative Analysis of Young Men’s Discussions about their Bodies

Farrah-Hani Imran, MBBS; Student; MRCS(IRL) MS(Plast Surg), University College Dublin, Dublin, Dublin, Farrah-Hani Imran, MBBS; Student; MBBCh MRCS MS(PlastSurg), University College Dublin, Dublin, Dublin, Lesley O'Hara, BA; MSc; PhD, University College Dublin, Dublin, Dublin, Fiona McNicholas, MBBS; MD; MRCPsych; FRCPsych, University College Dublin, Dublin, Dublin

In 2008, the National Men’s Health Policy of Ireland called for ‘a stronger evidence base to support the on-going development of policy and services for men’ and the need to develop measures ‘across different aspects of men’s health that can be monitored to evaluate changes in men’s health status over time’. Research would suggest that body image dissatisfaction is linked with negative health behaviours; however, research around body image dissatisfaction in males is limited. In Ireland, recent research would point to a growing trend of excessive exercise and use of body-building supplements amongst teenage boys but little is known about the extent and motivations of young men to engage in these behaviours and the association with positive or negative body image. With this in mind, the current study set out to explore men’s relationships with their bodies and the motivating factors influencing their diet and exercise behaviours. An exploratory study via 3 focus groups with 8 people in each was conducted, and the views expressed by the men were analysed using qualitative methods. There exists significant pressure on men to conform to particular male body image ideals, and to achieve a certain degree of masculinity both for performance and aesthetics. Pressures are perceived as originating both internally and externally, and pursued with different degrees with both positive and negative effects. A link between these pressures to conform and the impact on mental health is discussed, along with possible interventions designed to promote and maintain positive male body image and minimise any adverse effects.

T122: Dose-Dependent Effect of Childhood Trauma Exposure on the Cortisol Awakening Response in Adult Patients with Eating Disorders

Alessio Maria Monteleone, MD, Department of Psychiatry, Second University of Naples, Naples, Italy, Alessio Maria Monteleone, MD, Department of Psychiatry, Second University of Naples, Naples, Italy, Umberto Volpe, MD; PhD, Department of Psychiatry, Second University of Naples, Naples, Italy, Massimiliano Nigro, MD; PhD, Department of Psychiatry, Second University of Naples, Naples, Italy, Francesca Pellegrino, MD, Department of Psychiatry, Second University of Naples, Naples, Italy, Valeria Ruzzi, MD, Department of Psychiatry, Second University of Naples, Naples, Italy, Palmiero Monteleone, Professor, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy

It is widely accepted that childhood trauma is a non-specific risk factor for the development adult eating disorders (ED), and the hypothalamic-pituitary-adrenal (HPA) axis seems to be involved in mediating such a risk. Here we explored the impact of different types of childhood trauma and of concomitant exposure to multiple childhood traumas on the cortisol awakening response (CAR) of women with anorexia nervosa (AN) or bulimia nervosa (BN).Saliva samples were collected at awakening and after 15, 30, 60 min to measure cortisol levels by 121 women (44 AN patients, 36 BN patients and 41 healthy women). Participants filled in the Childhood Trauma Questionnaire to assess childhood trauma exposure.AN and BN patients reporting childhood maltreatments exhibited an attenuated CAR compared to non-maltreated ones. In the whole ED patient group, the CAR showed a progressive impairment with the increasing number of reported trauma types. No significant differences emerged in the CAR among patients who reported different types (emotional neglect or abuse, physical neglect or abuse, sexual abuse) of childhood trauma. Although significant negative correlations emerged between the type or the number of traumas and the CAR, only the number of traumas remained significantly associated with the CAR in a stepwise multiple regression analysis. Present findings confirm that childhood trauma is associated to an impaired CAR in adult AN and BN patients and demonstrate for the first time a negative dose-dependent effect of the traumatic load on HPA axis activity. These findings may suggest an intriguing correlation between childhood trauma exposure, HPA axis functioning and adult ED development.

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