Eating Disorders - Science topic

Please help to obtain studies linking these variables

Disclaimer: Vegan myself and spend some time in eating disorder research.

Currently, there are roughly three veganism "movements" at the same time: Their main motivations are: (1) animal rights, (2) environmental impact, (3) health. Empirically, the first two are on very stable grounds, the last is somewhat more unstable. For example, there is to date not much conclusive research showing health benefits of veganism vs. vegetarianism vs. diet with low (i.e., once a week) meat-intake. While there is increasingly good evidence that the former three diets have benefits over the standard "western diet".

My hypothesis would be that only the third group ("health") is at higher risk for eating disorders. I don't know of research on the topic and this is just my intuition. This group will likely be closely connected to the general "health/beauty/fitness" trends perpetuated by, e.g., instagram, influencers, certain brands, and the like. These trends itself have been shown to affect views and perceptions on body image, etc. So there is a obvious connection to eating disorder development. While this mostly would affect females, there is also a trend and some preliminary evidence for benefits of veganism in body building which, given the connection between body building, body image, muscle dysmorphia, and eating disorders, might again cause a statistical association between veganism and eating disorders in males.

On the other hand, I don't see a good reason to assume that the first two groups who are vegan out of ethical/environmental concerns should be excluded from ED studies. First, they might actually not be at higher risk for ED development. Second, this will, more and more with rising societal awareness of the terrible conditions in animal "production" and the strong positive impact of a plant-based diet on one's carbon foodprint, limit the number of eligible participants, making research harder. Third, again increasingly so with the number of people adopting a vegan lifestyle, this might actually introduce a bias as studies would then be less representative of the general population because a more or less relevant subgroup was excluded. This might be especially relevant for microbiom studies.

So, in conclusions: Maybe an assessment of the motivation for the participant's veganism would be a temporary solution? In the easiest case, a kind of Likert rating for each major motivation to then exclude those who are mostly vegan for health/fitness benefits? Of course, the correct solution would be to first assess whether my hypothesis above is correct to then apply it in participant selection...

Many thanks Louis! This is very helpful. I will discuss with my doctor and will trial a temporary small dose as she recommended and hopefully after full weight restoration my thyroid levels will normalize. I am already seeing an eating disorder specialist dietician.

Hi Jaclyn,

I have been across this conversation and thought that until today maybe you could find a good scale to measure food-related anxiety. Any thought? i will need a good scale to use it in my study population. Appreciate your response. Hiba

TRIPHALA - An excellent ayurvedic colon cleaner manufactured in India .

For mice models you can use plant based oils like olive oil, safflower oil, corn oil or animal based fats like lard, beef tallow in a composition providing 20-60% of total energy. There are many related studies.

Kristopher J. Brown Thanks!

Hi Elnaz

Here are some recent references on BED and Internet or smartphone treatment:

Keith

BODY SHAME is something NORMAL that can range from SHOCK to being seen naked, to a certain uncomfortable feeling that others (or even ourselves) witness possible deformations, even without being naked, scars, baldness, ravages of the passage of the years, etc.

On the contrary, BODY UNSATIFACTION IS ALREADY SOMETHING PATHOLOGICAL, the result of a deficit of Self-concept and / or Self-esteem or the framework, even, of a DYSMORPHOPHOBIA, with obsessive fixations and delusional ideas about normal parts of the body or with "defects" but the subject magnifies them in an abnormal way and not according to reality; A classic example would be that of Nevious Anorexia and Bulimia, in which patients, normally women, SEE FAT, VERY FAT even being extremely thin (and the well-known Silhouette Test is very eloquent: The patient attributes to herself a silhouette and / or a SIZE VERY HIGHER THAN THE ONE YOU REALLY HAVE ... but, DO NOT LIE, IT IS THAT YOU ARE PERCEIVED AND CONVINCED THAT IT IS SO; but as is known "being convinced of something does not mean being right")

If such "interruption" is due or is the result or result of a "forced" feeding (even nasogastric), sometimes by court order, it is not enough nor is it the "therapeutic objective", although obviously this is often necessary and even , essential (eg if there is a CAQUEXIA status); but even if menstruation even reappears, the "lanugo" disappears and weight is gained, and so on. WHILE DYSMORPHOPHOBIA IS NOT ADDRESSED AND THE ALMOST DELIROID PERCEPTION OF YOUR OWN BODY SCHEME IS CONTROLLED OR DISAPPEARED, there is NOTHING TO DO, as this is THE CORE OF SUCH PATHOLOGY AND ITS PATHOGNOMONIC ELEMENT

The essentials are:

-Congnitive Behavioral Treatment to combat altered / delirious perception of one's own body scheme and self-image

-Intervention "ad hoc", including with Systematic Desensitization and Reciprocal Inhibition for Dysmorphophobia.

-Implementation of Self-esteem and Self-concept.

-If necessary, a system -in an institutionalized intervention- of absolute elimination of positive reinforcements and of any "reward" or, even, attention to be achieved through programmed weight gain.

-Absolute prohibition of mirrors.

-Premack techniques to acquire desirable behaviors.

Training in Social Skills and Assertiveness.

-Individualized psychotherapy

-Control and advice from expert Nutritionists ... In any case, without any desire for prominence, you can see contributions in this regard here in "RG" of my Research Team and mine.

Thank you for sharing this question

I'm sorry; it hasn't come out completely ... so he continues:

-even in a "critical state" due to cachexia-; This being the case, many times we have to go to a Judge to order that such patients be fed (generally nasogátrically); BUT IF THIS IS NOT ACCOMPANIED BY AN INTERVENTION THAT INFLUENCES THEIR DYSMORPHOPHOBIA AND THEIR DELUSIONAL AUP-PERCEPTIONS, WHEN THEY ARE DISCHARGED, BECAUSE OF ALREADY HAVING AN "ACCEPTABLE" WEIGHT, THEY RETURN TO THE SAME.

On this subject, I allow myself to suggest -without any conceit or vanity, but as a Scientist and Clinician- that you read various contributions from me and from my Research Team, here in "RG", on this problem (various contributions to Congresses, Articles , Chapters in Books, Conferences, etc.). Thanks.

Hello Kah Yan, there are quite a few studies that have used the Malay version of the EAT-26, apart from the authors of the original study. I've attached some relevant papers that may help by suggesting further researchers you could contact, and you can do further searches in Google Scholar and other databases. Good luck! Rachel

Hello everyone, I am late to this discussion but wanted to add a few thoughts:

1) Using BMI in work with body image will likely almost always depend on the research question and if researchers want to control for body fat, but.....

2) As another researcher indicated BMI is limited. It is really just a proxy for body fat since the formula is simply based on height and weight. It should not be the first choice if other more precise measures can be used such as percent body fat (under water weighing, calipers, and possibly some electrical impedance measures if the produce scores considered valid and reliable) or assessments of muscularity through instruments like the Bod Pod which gives muscularity and BF%.

I know the assumptions but I need to know if I can use the same variable (i.e protein1 and protein2) related to two different food or If I had to sum or to calculate the medium of the protein to avoid the repetition of the variable.

S. Béatrice Marianne Ewalds-Kvist Thank you so much, I contacted the author for the questionnaire but I got no reply so I was trying to see if someone has the questionnaire available

Have you looked for a version for women? There may already exist one for ladies - and could possibly be adapted. Keep contacting the author, it's a busy time of year as the new academic year starts - try again in at the end of October.

Hope this helps :)

There are quite a lot of different questionnaires measuring different aspects of eating disorder symptoms. Some are free to use, and some do you have to pay for.

The Eating Disorder Examination Questionnaire (EDE-Q) and the Eating Disorder Inventory (EDI-2, EDI-3) are in regular use in our specialist eating disorder unit in Norway, and also in most of the other specialist units in Norway too. These questionnaires are measuring core ED symptoms (EDE-Q) and both ED symptoms and psychological symptoms (EDI)

As a measure for depression we use the Beck Depression Inventory (BDI).

As a measure for general psychopathology in the patients we use the Symptom Checklist (SCL-90R).

As a measure for interpersonal problems we use the the Inventory of Interpersonal problems (IIP64).

As a measure of body image problems we use the Body Attitude Test (BAT).

As a measure of Compulsive exercise we use the Exercise and Eating Disorders (EED).

All of these questionnaires are validated. The EED has been developed in our unit and was a part of my PhD. This questionnaire is attached to this message.

Kind regards

Dr. Marit Danielsen

تدريبات القوة عامل اساسي في الحياة اليومية

وانجازات الرياضين وخاصة العاب القوة فعاليات الرمي والوثب تحتاج تدريبات القوة

Hi Fazleh,

Type 2 Diabetes is not an eating disorder but has high comorbidity with it, see attached articles. People with Diabetes type 2 and risk factors for eating disorders (including those related to personality such as perfectionism, obsessiveness) are particularly at risk but those risk factors are no doubt different from risk factors for diabetes. Needing to be regimented,and self disciplined with food and to plan ahead is difficult for many since they cannot eat spontaneously and freely. When self esteem is low and/or the illness is not accepted there can be some 'rebelling' or experimenting with the limits of self-care. An extreme example is the manipulation of the use of insulin for weight loss purposes, which can be very dangerous and even fatal. So I believe that management of psychological aspects of dealing with the disorder is essential.

Rachel.

I think Felicity A. Cowdrey is on RG.

Dear Ina,

Ballet dancers with eating disorders seem to have higher levels of anxiety as well (Diogo et al. 2016, Liu et al. 2016), so maybe monitoring with the State-Trait Anxiety Inventory-T-6 might be useful.

Diogo MA, Ribas GG, Skare TL. Frequency of pain and eating disorders among professional and amateur dancers. Sao Paulo Med J. 2016 Sep 26:0. doi: 10.1590/1516-3180.2016.0077310516. [Epub ahead of print]. http://www.scielo.br/pdf/spmj/v134n6/1806-9460-spmj-1516_3180_2016_0077310516.pdf

Liu CY, Tseng MC, Chang CH, Fang D, Lee MB. Comorbid psychiatric diagnosis and psychological correlates of eating disorders in dance students. J Formos Med Assoc 2016;115(2):113-20. https://www.sciencedirect.com/science/article/pii/S0929664615000704?via%3Dihub

Best wishes from Munich,

Martin

I am currently working on research related to this paper, but it takes awhile to connect the ideas that are pertinent given the extensive nature of the publications regarding obesity. I have been invited to offer a presentation at the ICOCD meeting in San Francisco June 30 to July 3 2019.I am adding the abstract of this presentation. I also plan to submit an abstract to the annual meeting of the American Society for Nutrition that will be held in Baltimore in June.

The article that you are not mentioning is being increasingly cited as people look for new interpretations of why obesity is increasing around the world.

Hi there!

Look at Lessen, B (2011) Premature Infant Oral Motor Intervention (PIOMI) protocol. We have implemented this protocol with our infants in our level III unit.

With regards to the global score, the original Fairburn and Beglin recommendation was 4.0 I believe, but that has been shown to be extremely limiting.

Check out this paper! It does a good job highlighting some of the previous studies that have looked at this and also provides their ow recommendations.

Rø, Ø., Reas, D. L., & Stedal, K. (2015). Eating Disorder Examination Questionnaire (EDE‐Q) in Norwegian Adults: Discrimination between Female Controls and Eating Disorder Patients. European Eating Disorders Review, 23(5), 408-412.

May I refer you to this online open access Journal Special Issue on psycho-social dynamics of offering food and receiving food? Some of the articles and pieces are specifically about eating distress but editorially our interest has been in food practices

Thank you all kindly!

Hi Jenifer, and welcome to the field of eating disorders. It's great that you are wanting to familiarize yourself with research and I endorse Claire and Stephen's answers. Organizations such as the Academy for Eating Disorders and the Eating Disorders Research Society (who are holding their annual meeting next week in Leipzig, Germany) are great ways of keeping up with the latest research developments and clinical options and recommendations. Sign up for the AED conference in Chigago in April, 2018, I'm sure you'll benefit a lot from that. Also, take a look at what is published in professional journals on eating disorders - the International j of EDs; the European ED Review; Eating Disorders, Treatment and Prevention; the Journal of ED, Appetite, Eating and Weight Behaviors and more... You can look up the authors of articles that interest you and find more of their research. And meet a lot of them at the AED conference! Good luck, Rachel.

Hi Lesley, I am a clinician and researcher in the field of eating disorders and meet this a lot. I'm attaching one of those articles that you mention, showing that the 'voice' is really a problem.

I have found that teaching the person to talk back and argue against the 'voices' can be helpful, as is often done with automatic thoughts in CBT. For example a 14 year old boy with severe anorexia nervosa told me that every time he ate, 'voices' would tell him that he is fat, didn't need to eat etc. We sat together and made notes about how his healthy voice could answer the ED voice (e.g. you are trying to keep me in this horrible illness, everybody tells me I'm thin so you must be lying, I need to eat to be healthy, go back to school, eat with my friends, etc). Then he practiced saying these things out loud but he sounded unconvinced and spoke really softly so I helped him to say them convincingly and even shout out his statements, which was very difficult for him. It empowered him and helped a lot and he recovered.

The items are specified on page 5 of the article at the following link:

You can download the entire article, which is a manual for the scale.

Maybe considering two types of sexual selection is relevant: Intrasexual competition might cause same-sex competition on traits in such a manner that one moves away from the preferences of the opposite sex; and this might manifest in male and female models in magazines for either men or women being either slimmer/curvier or fit/very muscular. NB: sexually selected traits will be selected by increasing reproductive success, not the opposite.

Hola Stephane, 

para evaluar  la Escala de insatisfacción corporal en adolescentes PUEDES Como utilizar el Cuestionario EDI - 3. Además evalúa 8 escalas muy útiles para evaluar  Comportamientos Clínico de TCA.

Un saludo.

Thank you for the information!

Hello Douglas Wassenar,

Thank you for the link but i cannot have access to it. What is it about?

Dear Maria, 

some suggestions: 

Thank you!

Great question. The only published scale I'm aware of that explicitly taps addictive eating/food addiction is the YFAS, but I concur that the other two scales mentioned (the DEBQ and TFEQ) are also definitely worth considering. The difficulty lies in the fact that there is no clear, consensus definition of what "addictive eating" is, or even "addiction." Here is a link to an early paper we published examining this issue among women with binge-eating disorder. 

Dear Lasse,

I am not surprised by your findings. People are generally becoming busier, although I don't have any statistics on this. I think 20-30 minutes is quite a long way beyond the level of goodwill of time the average citizen would give to a stranger. My advice is therefore:

Hi Abigail,

I  think your research would greatly benefit from reviewing research ethics in the context of "insider researcher"status. Some call it The merit of an "Outsider-Within Perspective" Traditional research has often marginalized perspectives of those closely associated with certain subject matter by clinging to the "guardrail of neutrality" yet in reality there is no such thing as objectivity. "Objectivity "is  often viewed as a social construction to privilege certain perspectives on knowledge production than others. What you should be concerned about is how you can demonstrate and achieve validity and reliability. Pertinent literature on insider researcher will reveal that there will always be potential subjectivity when it comes to  such research, so there is need to acknowledge that, and perhaps what steps you intend to take to minimize potential  subjectivity(biases). It is accepted that the perspectives accessible to an insider are largely unobtainable to outsiders, and are thus valuable to filling gaps in scholarship lacking standpoint of those closer to what is being investigated. I hope this helps somehow.

Hello Gemma, I'm attaching an article that may be of interest, and hopefully of some use.

Rachel.

Dear Kushai, 

Check these papers out: 

Dear Anna, 

may these papers give you some ideas: 

Dear Bruno,

I am writing a manuscript about ADHD and eating disorder in primary students. Is that interest you? If yes, you can contact me by email. ltong@fudan.edu.cn

Hi Patricia,

I came across a thesis and two articles that may interest you:

Important.

See NICE guidelines:

 Bonjour Thomas, 

Je reviens vers vous concernant l'article sur les TCA en Chine  Lo AL, Hsu GLK. Extreme fasting among Daoist priestesses of the Tang Dynasty:an old Chinese variant of anorexia nervosa? History of Psychiatry. 2012; 23(3):342–8. Si vous ne trouvez pas l'article je vous l'enverrais

Dans ma thèse sur les TCA en Chine je parle de plusieurs cas dans l'histoire de la Chine. Sincères salutations,

Marion

Hi Joann,

These resources may be of interest to you:

Best wishes,

Stephen

Dear Malou,

I agree that the Marshmallow Test is not suitable for a home visit. Having done many home assessments myself, there are so many things that can distract the experiment conditions... I would personally advise against it. Keeping a child in a room for 15 minutes without distractors is virtually impossible at home. The kid could just get bored and grab a toy. 

For the waiting time, you would typically use 15 minutes for your age group. The original task used 15 minutes with 3.5 to almost 6 years old.

Best regards,

Hi Jim, thanks for the tips. I agree, a good drug would impact food motivation only, rather than bringing about any counter-obesity effect through some other effect such as on affective state in general. I think the binge eating model is very interesting and useful in many ways, though I wonder how closely it reflects human binge eating, where I suspect periods between binges are driven partially by guilt in addition to satiety. 

Hi Pat,

You may want to check these out:

The Use of Cognitive-Behavioral Music Therapy in the Treatment of Women with Eating Disorders by Russell E. Hilliard.

Music Therapy and Eating Disorders: A Single Case Study about the Sound of Human Needs by Susanne Bauer.

Music Therapy Interventions for People with Eating Disorders in an Inpatient Setting by Roberta Wigle Justice.

Dear John, 

Eating disordered persons are more open in their values. This means that they have a greater  willingness to re-evaluate norms and values compared to controls. 

J Eat Disord. 2015 Mar 11;3:3. 

Who do you think you are? - Personality in eating disordered patients.

Levallius J, Clinton D, Bäckström M, Norring C.

Author information

 

Abstract

BACKGROUND:

The Five-Factor Model of personality is strongly linked to common mental disorders. Yet the relationship between the lower orderpersonality traits (facets) of the model and eating disorder (ED) features remains unclear. The aim of the study was to explore how patients with non-anorexic ED differ from controls in personality and to examine the ability of personality facets to explain psychopathology.

METHODS:

Female patients with non-anorexic ED (N = 208) were assessed on general psychopathology, ED symptoms and personality as measured by the NEO PI-R; and were compared on personality to age-matched female controls (N = 94).

RESULTS:

Compared to controls, patients were characterised by experiencing pervasive negative affectivity and vulnerability, with little in the way ofpositive emotions such as joy, warmth and love. Patients were also significantly less warm and sociable, and exhibited less trust, competence, and self-discipline. Finally, they were less open to feelings, ideas and new experiences, yet more open in their values. Among patients, personality facets explained up to 25% of the variance in ED and general psychopathology.

CONCLUSIONS:

ED patients have distinct patterns of personality. Identifying and focusing on personality traits may aid in understanding ED, help therapists enhance the treatment alliance, address underlying problems, and improve outcome.

thank you very much, Beatrice, you are very helpful

Hi John, I don't know of any participatory studies carried out on wards, however, my first though was Professor Phil Barker who developed the Tidal Model.  He now lives in Scotland and I don't have a current contact address but he's very approachable if you can speak to him.  His work was wider than Eating Disorder and PD but he was a past-master at engaging service users and really involving them in their recovery.  His work inspired me in that he seemed to have a knack of connecting on a very basic and real level with those he worked with.  It would seem to me that any research work, or participatory enquiry, on wards would need to establish those fundamentals to be truly successful. All best, Heather

Effects of eating disorders on oral fungal diversity.

Back-Brito GN, da Mota AJ, de Souza Bernardes LÂ, Takamune SS, Prado Ede F, Cordás TA, Balducci I, da Nobrega FG, Koga-Ito CY.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2012

Eating disorders. Part I: Psychiatric diagnosis and dental implications.

Aranha AC, Eduardo Cde P, Cordás TA 

J Contemp Dent Pract. 2008 Sep 1;9(6):73-81.

Eating disorders part II: clinical strategies for dental treatment

Aranha AC, Eduardo Cde P, Cordás TA

J Contemp Dent Pract. 2008 Nov 1;9(7):89-96.

I treated two cases who suffered of anorexic symptoms and diabetes, one adult and one child. Both were females. I found it very difficult to cope with that symptomatologic co-presence, that obliged patients to focuse on body functioning. In the case of child diabetes offered a way to establish a better relationship with the mother, in the adult diabetes was a way to be in touch with the dead father.In both cases, the main difficulty was in joining the psychic reality, were the body was so preminent. Would you like to discuss about that? L

Donna, these are terrific! Better than what I have been able to get so far from AHS contacts. I assume you educate people about serving size to be able to use the STC tool. Actually, the Big Life tool also.....

Thank you!

This does sound like a very ambitious project. In general though if a hospital has electronic records like epic you should be able to easily populate data like you think of.

Great thank you Stephen

Thank you!

Very interesting!

Béatrice

Hello,

  I thought I had posted a response earlier, so I apologize if this is doubling down on it.

The ChIPS is a copyrighted for-profit interview sold by APPI. Here is the link to the information: http://www.appi.org/searchcenter/pages/SearchDetail.aspx?ItemId=8847

I haven't seen anything from the ChIPS group suggesting an update to match DSM-5. If others have more information, it would be great to share.

You might consider other interviews that might work that are free such as the KSADS (http://www.psychiatry.pitt.edu/node/8233).

To assess psychopathological symptoms and mental health, there are (respectively) two widely used measures: the BSI (Brief Symptom Inventory) and the MHI (Mental Health Inventory). I've worked with both, and they're both relevant and reliable.

you are welcome!

may you can use chicken 

Mouse and rat models could be used for  study of binge eating disorder

Thank you Lasse Bang, Thank you so much for your clear answer. I am also thankful to Mariana Sierra, for the submission...!!!

Are you looking for sites like this: http://www.eatingdisorderhope.com/recovery/self-help-tools-skills-tips

Self-Help & Recovery

Women, the Jewish Community and Eating Disorders – Food is a prevalent part of the Jewish community. The Jewish culture celebrates many holidays that involve food preparation and others involve fasting. Even the weekly planning for Shabbat focuses on three festive meals. So much focus on food can begin to affect a young impressionable Jewish woman.

The 12 Step Program of Recovery and Eating Disorders – Originally developed over 65 years ago by a small group of recovering alcoholics, the twelve-step program has become an important part of the recovery process and the foundation for many recovery programs. Though the twelve-step program was proposed by Alcoholics Anonymous as an approach to recovery from Alcoholism, the methods have been adapted to a process that addresses a wide-range of substance-abuse and dependency issues.

Health As a Recovery Tool – Eating disorders result in devastating health and medical consequences. Read these articles to learn more about this important topic.

Eating Disorders and Mindfulness – The practice of mindfulness is especially important to those struggling with eating disorders. Read these articles to learn more about this.

Eating Disorder Relapse – In eating disorder recovery, relapse prevention is critical. Read this valuable article to learn more about how to establish relapse prevention in your own journey.

The Object of Comfort – Often times, eating disorders develop as a means of coping through a traumatic or distressing period in a man or woman’s life. As eating disorders offer a false sense of control and security, it can be all the more difficult to let go of these damaging behaviors. Read this inspiring article to learn more about the healing process through recovery.

Walking in Recovery – Recovery is a long journey with many twists and turns, up and downs. Learn about the process of eating disorder recovery and the importance of humility.

Reviewed By: Jacquelyn Ekern, MS, LPC on March 10, 2014

Published on EatingDisorderHope.com, Resources for Eating Disorder Information and Treatment

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Content analysis of male participation in pro-eating disorder web sites.

Wooldridge, Tom; Mok, Caroline; Chiu, Sabrina. Eating Disorders: The Journal of Treatment & Prevention 22.2 (Mar 2014): 97-110.

Dear Eka,

have a look to the official webpage:

Best regards,

Alejandro

Terry, my answer would be too late for your textbook considerations. In my experience in teaching eating disorders as a doctoral elective, I've found Christopher Fairburn's Overcoming binge eating very readable, informative, and engaging. Among Russell Barkley's books on ADHD and defiant children, I like his Taking charge of ADHD the most because he wrote with compassion and authority. If you want to discuss these topics further, please email me at scheung@apu.edu. Best,

Stephen

I disagree with Judith- in so far as hunger and appetite are different constructs-

I would say more as they are both the same construct (a motivation to eat) but could be driven either by the homeonstatic (need for energy nutrients etc) or hedonic (how much we like/want something)-

The measure of energy intake (when truly ad libitum) is a more useful tool for measuring satiety, especially if you are trying to explain body weight changes.

Dear colleague,

When there is a medical problem like syncope, electrolyte disturbances, or orthostatic heart rate, we discuss the patient with our team and keep the patient on the paediatric board with psychological and psychiatric treatment als liason.when the somatic complications are solved the patient go back to the eating disordr department.

Hudson and Pope proposed that bulimia is part of what they called Affective Spectrum Disorder. Their concept proposed that there is a connection between many common brain disorders that seem to be increasing at a rapid rate in developed societies:

Dear Lonny, sorry it took me a while to respond! Your post is very interesting. The complexity of the relationship between genetic expression and behavioural ones is immense. This brings me back to the possible mediators of these relationships. I did have an idea, which is not based on any specific research, it is only a humble hypothesis based on the works of others. The construction of schemas from early life have a physiological basis, as I do not think that they are separate systems, we just do not have enough convergence of evidence to indicate definite relationships and would need far more sophisticated technology , which will still take time. Depending on the emotions associated with a schema, certain external events may trigger physiological vulnerabilities, and it is viable that discomfort/anxiety is a form of early warning system that multi-level organic and psychological damage may occur unless specific events are in some way avoided. That being said,different meta cognitive processes, direct cognitive processes,locking in certain dysfunctionalities (or functions) - see the works of Beck, and Wells and Matthews - that in turn may then trigger physiological reactions (with gene expression being altered) in an attempt to protect the emotional homeostasis of an individual and avoid allostatic load. I presume that this can be both functional and dysfunctional, so it could act as a protective factor from disease, or play a major role in it. The concept of a fear of disease/mortality could be conceptualized differently by people, and the need to maintain psychological functioning may override other factors, however once specific physiological alterations have occurred, dysfunctionality may be increased and interpreted from a content viewpoint as internal evidence of threat to homeostasis, thus the idea of different way to survive makes a great deal of sense to me.

Hope that I have explained myself well, let me know if I have.