Psychother Psychosom Med Psychol 2018; 68(08): e10
DOI: 10.1055/s-0038-1667895
SYMPOSIEN
Kinder- und Jugendgesundheit
Georg Thieme Verlag KG Stuttgart · New York

Rumination in Adolescents with Anorexia Nervosa: Cognitive-Affective vs. Neuroendocronological Aspects

S Ehrlich
1   Technische Universität Dresden, Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Dresden, Germany
2   Technische Universität Dresden, Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dresden, Germany
,
S Fürtjes
1   Technische Universität Dresden, Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Dresden, Germany
,
M Seidel
1   Technische Universität Dresden, Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Dresden, Germany
,
J King
1   Technische Universität Dresden, Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Dresden, Germany
,
R Biemann
3   Otto-von-Guericke University Magdeburg, Institute for Clinical Chemistry and Pathobiochemistry, Magdeburg, Germany
,
V Roessner
2   Technische Universität Dresden, Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dresden, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
06 August 2018 (online)

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Introduction:

Rumination about body weight as well as food is common in patients with Anorexia Nervosa (AN) and may be a maintenance factor. While rumination can generally be considered as a cognitive-affective aspect of AN, food-related rumination may be driven primarily by a physiological response to undernutrition.

Materials & Methods:

In the current longitudinal study, we integrate ecological momentary assessment of rumination and affect and plasma leptin levels (biological marker of undernutrition) collected from 33 adolescent AN patients. At the very acute stage and after short-term weight-restoration patients answered six times per day short questionnaires over two weeks.

Results:

Analyses via hierarchical linear modelling confirmed that rumination is closely linked to affect in AN before and after weight-restoration. Rumination about food decreased during weight-restoration and was correlated with leptin levels. In contrast, rumination about body weight/figure was not linked to leptin, persisted after weight gain, and showed stronger connections with affect.

Discussion:

Our results suggest that rumination about body weight/figure seems to be a cognitive-affective aspect of the disorder, but food-related rumination should be considered from a neuroendocrinological perspective.

Conclusion:

It is likely that food-related ruminative thoughts reflect a physiological symptom induced by undernutrition, similar to well-described leptin-associated changes in physical activity.