Conceptualizing eating disorder psychopathology using an anxiety disorders framework: Evidence and implications for exposure-based clinical research. (February 2021)

• Record Type: Journal Article
• Authors: Schaumberg, Katherine; Reilly, Erin E.; Gorrell, Sasha; Levinson, Cheri A.; Farrell, Nicholas R.; Brown, Tiffany A.; Smith, Kathryn M.; Schaefer, Lauren M.; Essayli, Jamal H.; Haynos, Ann F.; Anderson, Lisa M.
• Is Part Of: Clinical psychology review. Volume 83(2021)
• Publication Date: 2021-02
• Subjects: Eating disorder -- Anxiety -- Exposure therapy; Clinical psychology -- Periodicals; Psychology, Pathological -- Periodicals; Psychotherapy -- Periodicals; Psychology, Clinical -- Periodicals; Electronic journals; 616.89
• DOI: 10.1016/j.cpr.2020.101952
• Languages: English
• ISSNs: 0272-7358

Abstract

Abstract: Eating disorders (EDs) and anxiety disorders (ADs) evidence shared risk and significant comorbidity. Recent advances in understanding of anxiety-based disorders may have direct application to research and treatment efforts for EDs. The current review presents an up-to-date, behavioral conceptualization of the overlap between anxiety-based disorders and EDs. We identify ways in which anxiety presents in EDs, consider differences between EDs and ADs relevant to treatment adaptions, discuss how exposure-based strategies may be adapted for use in ED treatment, and outline directions for future mechanistic, translational, and clinical ED research from this perspective. Important research directions include: simultaneous examination of the extent to which EDs are characterized by aberrant avoidance-, reward-, and/or habit-based neurobiological and behavioral processes; improvement in understanding of how nutritional status interacts with neurobiological characteristics of EDs; incorporation of a growing knowledge of biobehavioral signatures in ED treatment planning; development of more comprehensive exposure-based treatment approaches for EDs; testing whether certain exposure interventions for AD are appropriate for EDs; and improvement in clinician self-efficacy and ability to use exposure therapy for EDs. Highlights: Eating disorders (EDs) and anxiety disorders evidence shared risk and significant comorbidity The current paper reviews the overlap between anxiety-based disorders and EDs We discuss how exposure-based strategies may be adapted for use in ED treatment. We outline future research directions for exposure-based therapies in EDs.