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Purpose Individuals with anorexia nervosa (AN) and bulimia nervosa (BN) frequently exhibit Non-Suicidal Self-Injury (NSSI), yet their co-occurrence is still unclear. To address this issue, the aim of this study was to elucidate the role of impairments in interoception in explaining the NSSI phenomenon in AN and BN, providing an explanatory model that considers distal (insecure attachment/IA and traumatic childhood experiences/TCEs) and proximal (dissociation and emotional dysregulation) risk factors for NSSI. Method 130 patients with AN and BN were enrolled and administered self-report questionnaires to assess the intensity of NSSI behaviors, interoceptive deficits, IA, TCEs, emotional dysregulation and dissociative symptoms. Results Results from structural equation modeling revealed that impairments in interoception acted as crucial mediators between early negative relational experiences and factors that contribute to NSSI in AN and BN, particularly emotional dysregulation and dissociation. Precisely, both aspects of IA (anxiety and avoidance) and various forms of TCEs significantly exacerbated interoceptive deficits, which in turn are associated to the emergence of NSSI behaviors through the increase in levels of dissociation and emotional dysregulation. Conclusions The proposed model provided a novel explanation of the occurrence of NSSIs in patients with AN and BN by accounting for the significance of interoception. Level of evidence : Level V–Cross-sectional observational study.

Purpose Clinical studies describe a higher risk in individuals with Gender Dysphoria (GD) to engage in disordered eating practices, as well as dietary restraint. To the present day, clinical assessments on eating psychopathology in GD are principally oriented towards assessing behaviors, rather than the lived experience underlying these behaviors. Methods A sample of 141 individuals with GD (40 assigned male at birth—AMAB, 101 assigned female—AFAB), 153 individuals from the general population and 294 patients with AN were enrolled. Body Uneasiness Test (BUT), the Eating Disorders Examination Questionnaire (EDE) and the Identity and Eating Disorders questionnaire (IDEA) were administered. Analysis of variance and linear models were employed to estimate group differences, adjusted for age, education, and body mass index. Results Body uneasiness (BUT global severity index: F value 47.44, p < 0.001), and eating behaviors (EDE total score: F value 66.19, p < 0.001) lied on a spectrum of severity between patients with AN (highest), individuals with GD (elevated) and the general population. Patients with AN reported markedly greater embodiment disturbances in comparison with both the general population and AMAB or AFAB individuals with GD (IDEA total score: minimum T value 4.03, p < 0.001). However, AMAB individuals with GD also reported moderate embodiment disturbances in comparison with the general population (IDEA total score: T value 3.41, p < 0.01). Discussion Lived experiences may better highlight core differences between GD and clinical populations of patients with eating disorders. Embodiment disturbances were also reported by AMAB individuals, suggesting a role for gendered expectations in embodiment. Level of evidence III, evidence obtained from cohort or case–control analytic studies.

The study aims to evaluate symptomatic differences through psychometric tools comparing patients in the early stages of psychotic development with those exhibiting a more established symptomatology. Our hypothesis was that the early phase in adolescent patients is accompanied by quantitatively and qualitatively distinct symptomatology compared to adults. We assessed 116 participants-consisting of 14 to 65 years old patients with psychotic or mood symptoms-using psychometric tools and a clinical interview. The tools explored psychotic, depressive and anxiety dimensions, to provide a multifaceted assessment of the recruited individuals and help at categorizing them into diagnostic subclasses. We compared patients with psychotic symptoms (early-onset and lifetime) to patients with mood disorders (unipolar depression or bipolar disorder without psychotic symptoms). Psychotic symptoms intensity was significantly higher in the early-onset group compared to the lifetime group and was markedly greater than in the two other groups. It was also observed that the intensity of anxiety and depressive symptoms in the psychosis group were significantly higher in the early-onset subgroup. Our findings suggest that the clinical presentation of early-onset patients, typically striking in its symptomatology, is reflected by elevated scores on scales not routinely used for psychotic symptoms. This may be attributed to the pervasive destructuring of personality and reality characteristic of early psychotic experiences.

Background: The relationship between eating disorder (ED) specific psychopathology and depressive symptomatology in EDs is often debated. The aim of this study was to provide an explicative model regarding the mechanisms by which enhanced cognitive-behavior therapy (CBT-E) might determine an amelioration of depressive symptoms in patients with anorexia nervosa (AN) or bulimia nervosa (BN). Methods: A total of 157 women with AN or BN and no history of childhood trauma or bipolar disorder were evaluated before treatment and after 12 months of CBT-E. Self-administered questionnaires were used to measure ED psychopathology and depressive symptoms. Results: All psychopathological measures improved after treatment, with no significant additional improvement with the concomitant use of antidepressants. Structural equation modeling using the bivariate latent change score approach showed that higher levels of depressive symptoms at baseline were associated with a worse longitudinal trend of ED psychopathology, and vice versa. Finally, the amelioration of ED psychopathology predicted the improvement in depressive symptoms at follow-up, whereas data did not support the inverse path. Conclusion: This study elucidated the complex longitudinal interplay between ED psychopathology and depression during CBT-E, underlining the importance of addressing ED symptoms as a primary target in the case of comorbidity between AN or BN and depressive symptoms.