Conceptualizing eating disorder psychopathology using an anxiety disorders framework: Evidence and implications for exposure-based clinical research

Katherine Schaumberg, Erin E. Reilly, Sasha Gorrell, Cheri A. Levinson, Nicholas R. Farrell, Tiffany A. Brown, Kathryn M. Smith, Lauren M. Schaefer, Jamal H. Essayli, Ann F. Haynos, Lisa M. Anderson

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations

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.

Original languageEnglish (US)
Article number101952
JournalClinical Psychology Review
Volume83
DOIs
StatePublished - Feb 2021

Bibliographical note

Funding Information:
This work was supported by the National Institute of Mental Health of the National Institutes of Health under award number T32 MH082761 (Drs. Anderson, Haynos, and Schaefer), T32MH0118261 (Dr. Gorrell), and K23 MH112867 (Dr. Haynos), K01MH123914 (Dr. Schaumberg), L30MH120619 (Dr. Schaumberg), K23MH123910 (Dr. Anderson). This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Funding Information:
Ann F. Haynos is an Assistant Professor in the Department of Psychiatry and Behavioral Sciences at the University of Minnesota. Dr. Haynos received her Ph.D. in clinical psychology from the University of Nevada, Reno in 2015, and completed a predoctoral internship at Duke University Medical Center and a postdoctoral fellowship at the University of Minnesota through the Midwest Regional Postdoctoral Training Grant in Eating Disorders Research T32. Dr. Haynos' research focuses on unifying psychology and neuroscience to elucidate and intervene upon the precise decision-making mechanisms that promote the development and maintenance of eating disorders, especially anorexia nervosa and other disorders of restrictive eating.

Publisher Copyright:
© 2020 Elsevier Ltd

Keywords

  • Anxiety
  • Eating disorder
  • Exposure therapy

PubMed: MeSH publication types

  • Journal Article
  • Review
  • Research Support, N.I.H., Extramural

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