Alexandra E Dingemans

GGZ Rivierduinen · Eetstoornissen Ursula

Background: Individuals with eating disorders show deficits in neuropsychological functioning which might preexist and underlie the etiology of the eating disorders and influence relapse. Deficits in cognitive flexibility, i.e., set-shifting and central coherence, might perpetuate the symptoms. Cognitive remediation therapy (CRT) was developed to...

Background: Identifying predictors of psychological outcome for patients with eating disorders may improve the effectiveness of treatment. Patients with different pre-treatment characteristics and symptoms may benefit from different therapies. This study aimed to identify potential predictors of treatment outcome in a large naturalistic cohort of...

Background: Despite the disabling nature of eating disorders (EDs), many individuals with ED symptoms do not receive appropriate mental health care. Internet-based interventions have potential to reduce the unmet needs by providing easily accessible health care services. Objective: This study aimed to investigate the effectiveness of an Internet...

The purpose of the present review is to provide a summary of the research findings on emotion regulation in Binge Eating Disorder (BED). Negative emotions and maladaptive emotion regulation strategies play a role in the onset and maintenance of binge eating in BED. Anger and sadness, along with negative emotions related to interpersonal experiences...

Executive functions are a set of cognitive processes that are necessary for the cognitive control of behavior. They play a role in mediating self-control, self-regulation and decision-making. It has been suggested that the inability to control eating behavior in binge eating disorder (BED) may indicate deficits in executive functioning. This may be...

Introduction Overvaluation of shape and weight is a critical component in understanding and diagnosing eating disorders. While the transdiagnostic model states that overvaluation of shape and weight is the core pathology of all eating disorders, this concept is not a criterion for binge-eating disorder. The lack of recognition of overvaluation of s...

Objective Obsessive compulsive disorder (OCD) and anorexia nervosa (AN) are conditions associated with poor cognitive flexibility, a factor considered to interfere with treatment, but research into the relationship between cognitive flexibility and treatment outcome is limited. This study explores whether baseline measures of cognitive flexibility...

Objective Economic evaluations of treatments help to inform decisions on allocating health care resources. These evaluations involve comparing costs and effectiveness in terms of quality of life. To calculate quality‐adjusted life years, generic health related quality of life is often used, but is criticized for not being sensitive to change in men...

Studies investigating motives for social networking sites (SNS) use amongst people with eating disorder (ED) symptoms are scarce. The uses and gratifications theory states that people actively select media content to gratify their individual needs and this may help to explain why individuals with eating disorder symptoms choose to expose themselves...

Early identification of individuals with Body dysmorphic disorder (BDD) is essential to direct them to appropriate care and to reduce the chance of developing or maintaining comorbid psychiatric disorders (like an eating disorder (ED)). The present study aimed to develop a simple screener, the Body Dysmorphic Disorder Screener for DSM-5 (BDDS-5), t...

Studies investigating motives for social networking sites (SNS) use amongst people with eating disorder (ED) symptoms are scarce. The uses and gratifications theory states that people actively select media content to gratify their individual needs and this may help to explain why individuals with eating disorder symptoms choose to expose themselves...

Objective: To optimize treatment recommendations for eating disorders, it is important to investigate whether some individuals may benefit more (or less) from certain treatments. The current study explored predictors and moderators of an automated online self-help intervention "Featback" and online support from a recovered expert patient. Methods...

Aims: Disordered eating behaviour (DEB) and diabetes distress are prevalent in adults with type 1 diabetes (T1D). Emotion regulation strategies, such as cognitive reappraisal and expressive suppression, are associated with DEB and managing stress in general. Here we examine the associations between DEB, diabetes distress, and emotion regulation st...

Background Major depressive disorder (MDD) is one of the most common mental disorders in adolescence carrying a serious risk of adverse development later in life. Extant treatments are limited in effectiveness and have high drop-out and relapse rates. A body of literature has been published on the association between distressing/ traumatic experien...

Purpose Most of the network approaches in eating disorders found the highest degree of centrality for symptoms related to weight and shape concerns. However, longitudinal analyses are scarce and may increase our insight of the complex characteristics and dynamics over time. In the current study, an alternative non-linear method to perform longitudi...

Objective: Many individuals with an eating disorder do not receive appropriate care. Low-threshold interventions could help bridge this treatment gap. The study aim was to evaluate the effectiveness of Featback, a fully automated online self-help intervention, online expert-patient support and their combination. Method: A randomized controlled t...

Objective: The primary aim was assessing the cost-effectiveness of an internet-based self-help program, expert-patient support, and the combination of both compared to a care-as-usual condition. Method: An economic evaluation from a societal perspective was conducted alongside a randomized controlled trial. Participants aged 16 or older with at...

Objective Anorexia nervosa (AN) and obsessive-compulsive disorder (OCD) share a neuropsychological profile characterized by cognitive inflexibility as evident in set-shifting problems, and by strong detail focus. Clinically, both patient groups display a strong rigidity which may be explained by these neurocognitive difficulties. Cognitive inflexib...

BACKGROUND Economic costs of mental disorders for society are huge. Internet-based interventions are often coined as cost-effective alternative to usual care, but evidence is mixed. OBJECTIVE The aim was to review the literature on cost-effectiveness of eHealth interventions for mental disorders compared to usual care and to provide an estimate of...

Background The economic costs of mental disorders for society are huge. Internet-based interventions are often coined as cost-effective alternatives to usual care, but the evidence is mixed. Objective The aim was to review the literature on the cost-effectiveness of internet interventions for mental disorders compared with usual care and to provid...

Purpose The ICEpop CAPability measure for Adults (ICECAP-A) assesses five capabilities that are important to one’s well-being. The instrument might be an important addition to generic health questionnaires when evaluating quality of life extending beyond health. This study aimed to conduct a psychometric assessment of the Dutch translation of the I...

Several studies have shown that obsessive-compulsive disorder (OCD), eating disorders (ED), autism spectrum disorders (ASD) and body dysmorphic disorder (BDD) share obsessive-compulsive (OC) symptoms and often co-occur, which could be seen as indicative of a common etiological basis. In addition, they also appear to have similarities in executive f...

Objectives The ICEpop Capability Measure for Adults (ICECAP-A) assesses 5 capabilities (stability, attachment, autonomy, achievement, and enjoyment) that are important to one’s quality of life and might be an important addition to generic health questionnaires currently used in economic evaluations. This study aimed to develop a Dutch tariff of the...

Background: Research into mental disorders has found mental imagery to be a maintaining factor for psychological distress. However, studies investigating mental imagery in eating disorders are scarce. Aim: The aim of the present study was to compare spontaneous mental imagery related to eating, weight and/or appearance and intrusive prospective...

Executive functions play an important role in mediating self‐control and self‐regulation. It has been suggested that the inability to control eating in Binge Eating Disorder (BED) may indicate inefficiencies in executive functioning. This study investigated whether executive functioning predicted cognitive behavioural therapy outcome in BED while a...

Background: Guideline-recommended therapies are moderately successful in the treatment of obsessive-compulsive disorder (OCD) and anorexia nervosa (AN), leaving room for improvement. Cognitive inflexibility, a common trait in both disorders, is likely to prevent patients from engaging in treatment and from fully benefiting from existing therapies....

Background: Major Depressive Disorder (MDD) in adolescence has a high prevalence and risk of disability, but current treatments show limited effectiveness and high drop-out and relapse rates. Although the role of distressing experiences that relate to the development and maintenance of MDD has been recognized for decades, the efficacy of a trauma-f...

Background: E-mental health has become increasingly popular in interventions for individuals with eating disorders (EDs). It has the potential to offer low-threshold interventions and guide individuals to the needed care more promptly. Featback is such an Internet-based intervention and consists of psychoeducation and a fully automated monitoring...

Introduction With the rise of camera phones, selfie-taking has become a normative part of our modern culture. However, little is known about how this behavior may relate to eating disorder (ED) characteristics, particularly in those who already have eating disorder symptoms of clinical severity. The current study investigated how selfie-posting and...

Objective The definition of recovery in eating disorders (EDs) according to researchers is not necessarily similar to the patient definition. This study aimed to explore the concept of recovery as assessed by those affected by an ED themselves. Method Participants from the Netherlands Eating disorder Registry (NER) who reported an (former) ED diag...

Background Many patients with an eating disorder report difficulties in regulating their emotions and show a high prevalence of self-injurious behaviour. Several studies have stated that both eating disorder and self-injurious behaviour help emotion regulation, and are thus used as coping mechanisms for these patients. We aimed to determine the pre...

https://www.sciencedirect.com/science/article/pii/S0149763417309272 Whether emotions affect eating, and in whom, has remained unclear. This meta-analysis assessed the effect of emotions on eating in both healthy and eating disordered individuals. Fifty-six experimental studies investigating the causal effect of emotions on eating behavior were sel...

The Risk factors for Binge Eating Disorder in Overweight (REO) questionnaire is a screening tool for nutritionists to discriminate between individuals with obesity with and without Binge Eating Disorder (BED). The first study tested the discriminative ability of the REO and identified an optimal cut-off value. In the second study this cut-off value...

Patients with complex and severe eating disorders often receive a number of ineffective or/and insufficient treatments. Direct referral of these patients to highly specialized tertiary treatment facilities in an earlier stage of the disorder is likely to be more (cost)-effective. The aim of the study was to develop a decision tool that aids clinici...

Background: In mental health care routine outcome monitoring (ROM) has become an important part of everyday clinical practice in the Netherlands. It is important that the questionnaires involved are sensitive to therapeutic change. The Brief Symptom Inventory (BSI) is a generic instrument that is widely used and that seems to be responsive to ther...

Background Anorexia nervosa (AN) and Obsessive Compulsive Disorder (OCD) are among the most incapacitating and costly of mental disorders. Cognitive Behaviour Therapy (CBT), medication, and combination regimens, to which in AN personalised guidance on weight control is added, are moderately successful, leaving room for more effective treatment algo...

Objective: To investigate the cost-utility of the internet-based intervention "Featback" provided with different levels of therapist support, in comparison to a waiting list. Method: This economic evaluation was conducted from a societal perspective and was part of a randomized controlled trial in which participants (N = 354) with self-reported...

This study aimed to review the emerging findings regarding E-health interventions for eating disorders and to critically discuss emerging issues as well as challenges for future research. Internet-based cognitive behavioral therapy and guided self-help have demonstrated promising results in terms of reducing eating disorder psychopathology. Emergin...

The present study aims to examine the influence of negative affect on decision making in women with anorexia nervosa (AN) compared to healthy control women and, secondly, to assess differences between the restrictive (ANR) and binge-purge (ANBP) subtypes. One hundred four women (32 with ANR, 32 with ANBP, and 40 healthy controls) participated. All...

Purpose of review: This review compares the literature on cognitive remediation therapy (CRT) for eating disorders with findings in the field of schizophrenia, and discusses future directions for CRT for eating disorders. Recent findings: First studies using a randomized controlled trial design show the added value of CRT for eating disorders. P...

The category 'eating disorder 'not otherwise specified'' (ednos) in dsm-iv is restricted to eating disorders of clinical severity that do not completely fulfil the criteria for anorexia and bulimia nervosa. The ednos category is, by definition, often regarded as a a residual category and in principle designed to incorporate a small group of patient...

Cognitieve remediatietherapie bij patiënten met een ernstige of langdurige eetstoornis nederlands-vlaams toponderzoek artikel Waarom dit onderzoek? Mensen met een eetstoornis hebben kwetsbaarheden in het (neuro)cognitief functioneren. De inhoud van hun denken is niet alleen star, maar ook de manier waarop zij denken, blijkt vaak rigide. Deze kwetsb...

This study investigates self-injury from the perspective of patients with anorexia nervosa. A phenomenological design was used. Twelve patients participated. Data were collected using a semi-structured interview guide. Participants display self-injurious behavior predominantly in situations when they are forced to eat. They are terrified of gaining...

Background: Several Internet-based interventions for eating disorders have shown their effectiveness. Still, there is a need to refine such interventions given that most existing programs seem to be limited by their static 'one-size-fits-all' approach. 'Featback', an Internet-based intervention for symptoms of eating disorders provides a more indi...

Objective: To review the literature regarding internet-based treatment of eating disorders (ED). Method: Relevant studies were identified by searching electronic databases (including Medline, Embase, PsycInfo, and Web of Science). Eligible studies evaluated an internet-based treatment for ED, or an ED treatment that included at least one interne...

This study compared maladaptive core beliefs of eating-disordered groups (full and subthreshold syndrome) and healthy controls and investigated the association between eating disorder symptoms and core beliefs. Participants were compared on self-report measures of core beliefs (YSQ) and eating disorder psychopathology (BITE). Anorexia nervosa (AN;...

A randomized controlled trial (N = 52) was conducted comparing cognitive–behavioral therapy with a waiting listcontrol group to identify mediators and predictors of treatment outcome. Reduction of weight concerns mediated abstinence of binge eating at post-treatment. Abstinence was marginally mediated by changes in eating and shape concerns, depres...

Body dysmorphic disorder (BDD), an abnormal preoccupation with perceived defects in one or more body parts, and eating disorders (ED) share several essential clinical features, making it sometimes difficult to differentiate between the two disorders. The aims of this study were to assess the prevalence of BDD in patients with ED and to compare char...

Although Binge Eating Disorder (BED) is associated with obesity and unstable weight and the diagnosis was originally predicated with the obese in mind, obesity is not a criterion for BED. In fact, BED is not uncommon in nonobese individuals. The aim of this study was to compare the psychopathology of obese (BMI >30) and nonobese individuals (BMI <...

Pro-ana is de naam van een online groepering die (vooral) bestaat uit jongeren met problemen die zich actief manifesteren op internetfora, chats en websites. Daar wordt informatie geboden en er vindt interactie plaats die vooral gericht is op de promotie, ondersteuning en onderhoud van eetstoornisgebonden gedrag. In deze bijdrage gaan we nader in o...

Sad people may indulge in fattening snacks because they believe that eating will repair their mood. To test whether (1) changes in expectations and mood had an effect on caloric intake and (2) depressive symptoms moderated caloric intake, 73 women with binge eating disorder were randomly assigned to a condition in which expectations about food and...

This thesis focuses on patients with Binge Eating Disorder. The thesis consists of three parts. In the first part the validity of the diagnosis of BED will be discussed. The results of two literature reviews and an empirical cross-sectional study suggested that BED is a distinct eating disorder and should be added to a next version of the DSM. In t...

Overeating may be a consequence of the suppression of negative emotions, by depleting self-control resources. This experiment investigated whether (a) there is a causal relationship between the suppression of negative emotions, negative mood, and overeating in people with binge eating disorder (BED) and whether (b) this relationship is increased in...

A randomized controlled trial (N = 52) was conducted comparing cognitive–behavioral therapy with a waiting list control group to identify mediators and predictors of treatment outcome. Reduction of weight concerns mediated abstinence of binge eating at post-treatment. Abstinence was marginally mediated by changes in eating and shape concerns, depre...

Binge eating disorder (BED) is a new proposed eating disorder in the DSM-IV. BED is not a formal diagnosis within the DSM-IV, but in day-to-day clinical practice the diagnosis seems to be generally accepted. People with the BED-syndrome have binge eating episodes as do subjects with bulimia nervosa, but unlike the latter they do not engage in compe...

Both the skin and the brain develop from the same ectoderm and it is thought, therefore, that dermatoglyphics are informative for early disturbances in brain development in schizophrenia. This study was aimed at investigating the differences in both digital and palmar dermatoglyphic indices between twins discordant for schizophrenia and control twi...

Social phobia frequently occurs in the general population but is probably underreported due to comorbid disorders which mask the social phobia. Another reason might be that patients do not consult their general pratitioner due to embarrassment or an estimation of their condition. There are several treatments available for social phobia, but not eno...

achtergrond De vreetbuistoornis (binge eating disorder) is een ‘nieuwe’ stoornis, waarvan de onderzoekscriteria in 1994 in de dsm-ivzijn opgenomen. doel Dit artikel heeft tot doel meer bekendheid te geven aan deze nieuwe eetstoornis. Er wordt een overzicht gegeven van de kenmerken, diagnostische criteria, beloop en behandeling. methode Literatuuron...

Objective: The authors assessed the effects of nutritional deficiency during the first trimester of pregnancy on brain morphology in patients with schizophrenia. Method: Nine schizophrenic patients and nine healthy comparison subjects exposed during the first trimester of gestation to the Dutch Hunger Winter were evaluated with magnetic resonanc...

ties. Conclusions: Nutritional deficiency during the first trimester of gestation resulted in an increase in clinical brain abnormalities and was associated with aberrant early brain development in patients with schizophrenia. Stunted brain development secondary to factors that affect brain growth during the first trimester of gestation may thus be...

The role of changes in ego- and exocentric spatial relationships on perceptual judgements about visual displacement was investigated in this study. Subjects were asked to indicate whether a dot in a test stimulus was displaced compared to a dot in a reference stimulus. Subjects were given explicit instructions to report displacement relative to the...