Elena Tenconi

Background: Anorexia nervosa (AN) involves restrictive eating and marked difficulties in emotion regulation and cognitive flexibility. Cognitive Remediation and Emotion Skills Training (CREST) targets these domains, but outcomes may vary by psychological profile and adverse childhood experiences (ACEs). This study examined the associations of emotional–cognitive profiles and ACEs with treatment response following CREST in inpatients with AN. Methods: We studied 198 female inpatients with AN who completed baseline and post‐treatment assessments after an 8‐week group CREST programme. Cluster analysis of the Difficulties in Emotion Regulation Scale (DERS), Toronto Alexithymia Scale‐20 (TAS‐20), Detail and Flexibility Questionnaire (DFLEX), and Obsessive–Compulsive Inventory–Revised (OCI‐R) identified subgroups. Outcomes (ΔEDE‐Q, ΔDFLEX, ΔTAS, ΔBMI) were compared across clusters. Childhood Trauma Questionnaire (CTQ) subscales were tested in multinomial regression and moderation models. Results: Three clusters emerged: Cluster 1 (low impairment), Cluster 0 (moderate impairment), and Cluster 2 (globally impaired). Groups differed in age, illness duration, BMI, and adversities exposure (all p < 0.05). Psychological outcomes differed: ΔDFLEX (H = 63.7, p < 0.001) and ΔTAS ( p < 0.001), with Cluster 2 showing the greatest gains. Emotional abuse was positively associated with both the moderate and globally impaired profiles, whereas physical abuse specifically predicted the globally impaired profile. Sexual abuse was inversely associated with both impaired profiles. Moderation analyses indicated that associations between ACE severity and psychological change varied across emotional–cognitive profiles, with direction and magnitude differing by outcome and ACE subtype. Conclusions: Greater short‐term psychological changes were observed in the globally impaired profile, although baseline severity warrants cautious interpretation. Adverse childhood experiences were associated with profile membership and heterogeneous patterns of psychological change across profiles.

Aims: Anorexia nervosa (AN) is a severe, often enduring disorder with scarce biological treatments, largely unable to address its core implicit features: habit‐like food restriction and body‐experience disturbances. We report a single‐case application of resting‐state connectivity‐guided intermittent theta‐burst stimulation (iTBS) to the posterior parietal cortex (PPC), a hub for body representation, peripersonal space, and affordance‐based action. Methods: A 31‐year‐old woman with 12 years of treatment‐resistant restricting AN, enrolled in an ongoing sham‐controlled feasibility trial, underwent 20 active iTBS sessions to an individualized left‐PPC site maximally coupled with a body‐representation × affordance reference network, assessed at baseline, post‐treatment, and four‐month follow‐up. Results: The protocol was fully feasible and well tolerated, without significant adverse events. Clinical change was gradual, with most of the weight gain occurring after the stimulation period: BMI rose from 15.65 to 16.01 at four‐month follow‐up and 16.40 over subsequent clinical follow‐up. Blinded global improvement was minimal; anxiety fell below threshold, whereas eating‐disorder and body‐shape scores remained at floor. Target–reference connectivity increased in the a priori direction, toward the healthy‐control mean. Exploratory measures changed heterogeneously, only partly tracking engagement. Conclusion: This case supports the feasibility and mechanistic plausibility of individualized parietal targeting in enduring AN, motivating a controlled trial to test its efficacy. Trial Registration: The parent trial is registered on ClinicalTrials.gov (NCT07106645)

Background: The Gender Variance Scale (GVS) was developed to assess self-perceived masculinity and femininity across diverse gender identities, including binary and non-binary experiences. To date, no validated Italian version was available. Methods: A total of 356 participants (192 transgender and gender-diverse [TGD], 164 cisgender) completed the Italian GVS and the SF-12 Health Survey. Translation and cultural adaptation followed international guidelines. Psychometric evaluation included confirmatory factor analysis (CFA), internal consistency, test–retest reliability (n = 63), convergent validity with health-related quality of life, and group comparisons across gender identity categories. Results: CFA supported the original two-factor model (CFI = 0.916, TLI = 0.905, RMSEA = 0.076, SRMR = 0.053). Internal consistency was high (α = 0.89). The GVS distinguished between gender identity groups: TGD participants scored higher than cisgender peers, and non-binary individuals reported significantly lower scores than both binary groups. Test–retest reliability was strong (r = 0.87–0.99; ICC = 0.992–0.996). Conclusions: The Italian GVS is a valid and reliable measure of gender variance. It provides clinicians, researchers, and educators with a culturally appropriate tool to assess gender expression and support inclusive practices in both community and clinical contexts.

Objective: Emerging research suggests that autistic traits and sensory sensitivities are prevalent among individuals with eating disorders (EDs), particularly females. Traditional diagnostic approaches may overlook the heterogeneity of neurodevelopmental features within this population. A person‐centered approach could uncover meaningful subgroups and guide individualized treatment strategies. This study aimed to identify neurocognitive profiles among cisgender female ED patients, focusing on autistic traits, sensory sensitivity, social cognition, and clinical severity, through a dimensional and person‐centered clustering approach. Method: A total of 164 cisgender female patients were assessed using the Autism Spectrum Quotient (AQ‐10), Girls Questionnaire for Autism Spectrum Condition (GQ‐ASC), Sensory Perception Quotient (SPQ‐10), Story‐based Empathy Task (SET), and clinical measures including the Eating Disorder Examination Questionnaire (EDE‐Q), Body Uneasiness Test (BUT), and Symptom Checklist‐90‐Revised (SCL‐90‐R). Hierarchical cluster analysis (Ward's method) was conducted on standardized scores. Between‐cluster comparisons and multinomial logistic regression assessed the robustness and predictive validity of the cluster solution. Results: Four distinct clusters emerged, differing significantly in autistic traits, sensory sensitivity, social cognition, and ED severity (all p < 0.001). Profiles included a neurodivergent high‐risk group, a cognitively compensated group, a sensory‐reactive group, and a classically symptomatic group. Multinomial logistic regression predicted cluster membership with 94% accuracy. Discussion: Neurodevelopmental dimensions meaningfully differentiate ED subgroups and may inform more personalized, stratified care. These findings highlight the importance of integrating autistic traits, sensory processing, and social cognition into ED assessment and treatment planning. Public Significance Statement: This study identifies four distinct neurodevelopmental and clinical profiles among women with eating disorders, defined by differences in autistic traits, sensory sensitivity, and social cognition. Understanding these profiles can help clinicians recognize the diversity of presentations in eating disorders and adapt interventions to the specific needs of each individual, particularly those with neurodivergent features, ultimately promoting more personalized and effective care.

Objective: Eating disorders (ED), including bulimia nervosa (BN) and binge eating disorder (BED), are characterised by dysfunctional eating behaviours and maladaptive emotional regulation tied to concerns about body image. This study investigates the emotional and cognitive impacts of social exclusion and overinclusion on individuals with ED using the Cyberball task, a computerised simulation of social interaction, to examine the role of early maladaptive schemas (EMS) in these responses. Method: The sample included 124 women: 34 with BN, 26 with BED, and 64 controls, assigned to either an ostracism or overinclusion condition. Emotional responses were measured using PANAS before and after the Cyberball task, and EMS were assessed via the Young Schema Questionnaire. Mediation models were applied to explore EMS effects on emotional responses. Results: Participants with ED showed unique emotional patterns compared to controls across both Cyberball conditions. In the overinclusion condition, controls experienced increased positive affect, whereas individuals with ED showed no significant change. During ostracism, ED participants reported reduced negative affect, suggesting complex reactions to social exclusion. EMS were found to mediate emotional responses, particularly in the overinclusion condition. Discussion: The findings underscore the distinct social‐cognitive and emotional effects of interpersonal interactions on individuals with BN and BED, emphasising the importance of addressing EMS and social cognition in treatment. Future research should focus on refining our understanding of social perception and emotional skills in ED populations, particularly within the bulimic spectrum.

Eating disorders—including anorexia nervosa (AN), bulimia nervosa, and binge eating disorder—are clinically distinct but exhibit symptom overlap and diagnostic crossover. Genomic analyses have mostly examined AN. We conducted the first genomic meta-analysis of binge-eating behaviour (BE; 39,279 cases, 1,227,436 controls), alongside new analyses of AN (24,223 cases, 1,243,971 controls) and its subtypes (all European ancestries). We identified six loci associated with BE, including loci associated with higher body mass index (BMI) and impulse-control behaviours. AN GWAS yielded eight loci, validating six loci. Subsequent polygenic risk score analysis demonstrated an association with AN in two East Asian ancestry cohorts. BE and AN exhibited similar positive genetic correlations with psychiatric disorders, but opposing genetic correlations with anthropometric traits. Most of the genetic signal in BE and AN was not shared with BMI. We have extended eating disorder genomics beyond AN; future work will incorporate multiple diagnoses and global ancestries.