What do our researchers think about the EOSC? An interview with Isabel Krug

What do our researchers think about the EOSC? An interview with Isabel Krug

What do our researchers think about the EOSC? An interview with Isabel Krug


23 Apr 2020

by: Katharina Flicker, TU Wien

Researchers are at the very heart of the EOSC. So, what do our researchers say after more than a year after the launch of the initiative? How do they think will they benefit from the EOSC? What are and what can be their roles? Let’s see what clinical psychologist Isabel Krug has to say.

Interview with: Isabel Krug, Senior Lecturer in Clinical Psychology, University of Melbourne

Krug is a Regular Member of the Academy for Eating Disorders (AED), the Australian and New Zealand Eating Disorder Organization, as well a Member of Euroscience Open Forum (ESOF), of the Academy for Eating Disorders and of the Österreichische Gesellschaft für Essstörungen (ÖGES) (Austrian Eating Disorder Organization). She won awards such as the Intra-European Marie-Curie fellowship, the Teaching Award in Postgraduate studies at the School of Psychological Sciences. Krug’s PhD in Clinical and Health Psychology was awarded with the best PhD thesis Award 2008. For more information on Isabel Krug, please visit this link.

Facilitating global collaborations as well as collaborations of inter and multi-disciplinary teams

KF: What does your work currently focus on?

IK: My research is in clinical psychology and focuses on eating disorder populations, but I am also looking at disordered eating and body dissatisfaction amongst normal populations. My research covers the severity spectrum from normal eating / body image to clinical disordered eating behaviours / body dissatisfaction.

KF: Why are you doing the work that you are doing?

IK: I am interested in eating disorders because I feel that it is something that everyone encounters. Everyone is confronted with eating all the time. It is not like other problems that you can say I am just taking a break from it. We do have to eat to survive. And I am intrigued by the fact of why people have abnormal eating behaviors. I also think that the eating disorder area is a lot less researched than other mental health problems. Anorexia has the highest suicide rate of all mental illnesses. If you look at abnormal eating patterns within the community, prevalence can vary enormously. Being dissatisfied with one’s body has become a norm that people don’t question anymore. I am intrigued to find out why people develop eating disorders and how we can improve prevention and treatment for those people affected by this illness that robs the life of so many people.

KF: What data are you working with and how do you collect it to answer your research questions?

IK: I work with different data sets and they vary a lot. For instance, when I was doing my PhD and my postdoc in Spain, I worked at an eating disorder unit and had access to clinical data.  Each patient who was coming to the unit was asked to fill in a survey to be part of a standardized assessment. Throughout the years, the unit has been able to establish a large database of clinical eating disorder cases, which we have used to answer questions about the best classification of eating disorders, risk and protective factors for eating disorders as well as treatment outcome studies. In the last couple of years in Melbourne, it has been a little bit harder for me to access clinical data. This is mainly because I am now based at a university setting and not a clinical hospital anymore. We now do a lot of community-based surveys to assess women at risk for eating disorders and body dissatisfaction. For various of our studies, we use ecological momentary assessment, which entails data collection through a smartphone app on certain eating disorder behaviours and cognitions various times a day for approximately a week.

KF: Are there any (data) challenges that you are facing?

IK: A lot of things in the research I do could be automated! I do spend a lot of time on bureaucracy.  For instance, ethics is very time consuming. This is especially the case when I want to access a clinical eating disorder population at a local hospital. It is also very challenging to establish research relationships with clinical units, because the clinical staff is often overburdened and doesn’t want to take on any extra work related to the research we would like to do. Hence, it is very difficult to establish a research-practice integration momentum. However, I feel fortunate that I still have ongoing collaborations with my work colleagues in Europe, who have large clinical datasets, which I am allowed to use.

KF: In an ideal (future) research environment, what kind of services would you want? What would you want to be able to do?

IK: I would be delighted to be able to combine clinical datasets on eating disorders from different countries. A lot of times researchers use similar measures, which would allow to harmonize datasets to answer exciting research questions using advanced statistical techniques (e.g. network analyses, machine learning). Furthermore, large datasets would also allow to assess differences across a range of eating disorder subtypes (e.g. Anorexia, Bulimia, Binge Eating Disorder, Otherwise Specified Feeding and Eating Disorders (OSSFED)). I’m particularly intrigued by OSFED, which is the main category of eating disorders that does not fall into the established eating disorders of anorexia and bulimia. We currently know very little about this eating disorder category, mainly due to its heterogeneity.

I would also like to see more integration of different biological, psychological and environmental risk factors, in order to be able to develop and test a multi-factorial risk factor model for eating disorders. Until the present moment, most risk factor studies have been assessed mainly in isolation. Genome -wide association studies (GWAS) on Anorexia, have a range of biological, psychological and environmental data available to assess, but until the current moment these collaborations have mainly focused on the genetic risk factors for Anorexia Nervosa. The datasets shared in initiatives such as GWAS, do allow however to combine other psychological (e.g. comorbidity, eating disorder and general psychopathology) as well as personality risk factors that are available to analyze. It would be interesting to combine all these different risk factors into the same analyses to see which factors have the highest predictive power for eating disorders as well as the different subtypes of eating disorders.

KF: You mentioned the need of combining biological, environmental, social and clinical data before. How does your field benefit from interdisciplinary research?

IK: In my area an inter- and multidisciplinary approach is very important. For instance, for the machine learning methods that are currently used to predict risk you need statistical and engineering knowledge. For the genetic analyses, you need the biological know-how and for the GWAS you need to be very good at processing very large datasets, which is only manageable with extensive bioinformatics expertise. However, it is of course essential to always be able to relate these findings back into a clinical context. I guess that’s where my clinical skillsets are being asked for. It is impossible to acquire all these skillsets as one individual person. It is therefore essential to collaborate with people who are experts in these different fields to be able to move the eating disorder research field forward, with the hope of improving prevention / treatment programs for those affected by the illness.

KF: Now, getting back to all the things you said concerning the challenges that you are facing in research and interdisciplinary research.  What would you need the EOSC to be or to offer to support your research endeavors?

IK: As a European living in Australia, I would really like to maintain and start new collaborations in Europe. I mainly know people working in the eating disorder field, but research on cross-disorders and other disciplines is becoming more and more important. Hence, facilitating collaborations from an inter and multi-disciplinary team, would certainly allow to address exciting and timely research questions, that won't be able to be answered in silo. Finding ways to automate administrative burdens to facilitate collaborations amongst different countries, especially within a clinical setting, would also be vital to progress research. Finally, being far away, I would also like to find out more about funding opportunities that are targeting research exchanges between Europe and other parts of the world, e.g.  Australasian countries.

KF: Thank you.

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