1,721,502 research outputs found
Anorexia Nervosa, Theory and Treatment: Where Are We 35 Years on from Hilde Bruch's Foundation Lecture?
No full textHilde Bruch's foundation lecture in 1982 is a milestone from which to survey current theory and treatment for anorexia nervosa. Bruch described problems in body perception, emotion processing and interpersonal relationships as core theoretical aspects of the illness and built her theory of psychopathology on these aspects, as well as on animal studies on attachment. She also noted that many psychological problems result as consequence of starvation. In the first part of this paper, we parse Bruch's clinical descriptions into elements of psychopathology (disturbances in body perception, attachment, emotion expression, perception and regulation, social comparison, interpersonal, and family and therapeutic relationships), in order to assemble and update the theoretical evidence for a model of the illness. In the second part, we describe and extend her description of three core targets of treatment: family relationships, patient's inner confusion and nutritional restoration. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association
Treatments in eating disorders: Towards future directions
No full textThe aim of this paper was to present a review of treatments currently available for eating disorders. We review high-quality level evidence-based trials published in the Cochrane Library for anorexia nervosa, bulimia nervosa, eating disorders not otherwise specified and binge eating disorder. Cognitive behavioural therapy is the gold standard for the treatment of bulimia nervosa and binge eating disorder. Whereas treatments currently available for Anorexia Nervosa appear inadequate. Incorporating the family in treatment is of value for young people. New approaches addressing nutrition, cognitive styles and interpersonal relationships show promising findings in the treatment of these life threatening illnesses
The use of guided self-help incorporating a mobile component in people with eating disorders: A pilot study
No full textObjective: The aim of this pilot study was to test the acceptability and benefit of a guided self-help intervention incorporating a mobile component in eating disorders (EDs). Method Eighteen people with Anorexia Nervosa and eleven people with Bulimia Nervosa were included in the study for 3 weeks and self-report and behavioural assessments were made before and after the intervention which included 10 video clips, a manual, and limited guidance. Results: The most reported positive comment associated with the use of the vodcasts was the increased awareness about the illness. Adherence was good (29/31 subjects completed). A medium sized increase in Body Mass Index was found in participants with Anorexia Nervosa, and significantly lowered EDs and mood symptoms (effect size range = 0.72/1.35), and improvement in cognitive flexibility were reported post-intervention. Discussion: A guided self-help intervention incorporating a mobile component was both acceptable and associated with symptom change in people with EDs. © 2013 John Wiley & Sons, Ltd and Eating Disorders Association
Eating in eating disorders
No full textThe aim of this paper is to bring eating back into the centre of the eating disorder discourse. The ability to interrogate and understand the central processes of appetite has increased considerably since the discovery of leptin and the ability to observe brain function with scanning methodologies. This has led to substantial progress in understanding the biological causative and maintaining factors in eating disorders, opening up the possibility of translating the latest findings into new forms of treatment. The biological mechanisms underpinning symptoms evolution and course of illness will first be described, follows by a discussion on integrating the research evidence in fear and feeding into patient care. © 2011 John Wiley & Sons, Ltd and Eating Disorders Association
A three-phase model of the social emotional functioning in eating disorders
No full textBackground Problems with social emotional functioning are an important part of eating disorder psychopathology. Aim This study aimed to propose a model of social emotional functioning before and during the illness and to explain the consequences for those involved. Method We propose a three-phase model of social and emotional processes as both causal and maintaining factors in anorexia nervosa. The predictions from this model are examined, and we consider the relevance for treatment. Results The evidence base for the theoretical model is presented: Phase 1 describes causal predispositions and environments, Phase 2 notes the way in which the symptoms themselves impact on brain function and social cognition and Phase 3 explains the reactions of close others. Conclusions A three-phase model including interpersonal and socio-emotional elements can be used to shape and plan treatment interventions. Understanding causal chains and consequences can give a rationale for change and frame therapeutic interventions. © 2012 John Wiley & Sons, Ltd and Eating Disorders Association
Emotion recognition deficits in eating disorders are explained by co-occurring alexithymia
No full textPrevious research has yielded inconsistent findings regarding the ability of individuals with eating disorders (EDs) to recognize facial emotion, making the clinical features of this population hard to determine. This study tested the hypothesis that where observed, emotion recognition deficits exhibited by patients with EDs are due to alexithymia, a co-occurring condition also associated with emotion recognition difficulties. Ability to recognize facial emotion was investigated in a sample of individuals with EDs and varying degrees of co-occurring alexithymia, and an alexithymia-matched control group. Alexithymia, but not ED symptomology, was predictive of individuals’ emotion recognition ability, inferred from tolerance to high-frequency visual noise. This relationship was specific to emotion recognition, as neither alexithymia nor ED symptomology was associated with ability to recognize facial identity. These findings suggest that emotion recognition difficulties exhibited by patients with ED are attributable to alexithymia, and may not be a feature of EDs per se
The impact of induced positive mood on symptomatic behaviour in eating disorders. An experimental, AB/BA crossover design testing a multimodal presentation during a test-meal
No full textObjective: The aim of this study was to test the impact of a multimodal positive mood vodcast including pleasant images, background uplifting music and a script designed to elicit positive mood on eating disorders-related symptoms in participants suffering from an Eating Disorder (ED) and healthy controls (HCs). Method: Forty-two women with an ED (Anorexia Nervosa [AN]: N = 19; Bulimia Nervosa [BN]: N = 23) and 36 HCs were included in an AB/BA cross-over design which compared the use of a positive mood induction procedure ("positive mood vodcast") with a control condition (i.e. blue static background, neutral music, and script describing objective facts) during a test-meal. Self-report measures and behavioural tasks were completed before and after the test-meal. Results: The positive mood vodcast was associated with greater consumption of the test meal in the AN group; reduced vigilance to food stimuli and lower anxiety in the BN sample and no significant changes in the HC group. Discussion: The use of a positive mood vodcast was associated with some beneficial effects in the context of an experimental test-meal in participants with an ED
Basal ganglia volume and shape in anorexia nervosa
Full text linkBackground: Reward-centred models have proposed that anomalies in the basal ganglia circuitry that underlies reward learning and habit formation perpetuate anorexia nervosa (AN). The present study aimed to investigate the volume and shape of key basal ganglia regions, including the bilateral caudate, putamen, nucleus accumbens (NAcc), and globus pallidus in AN. Methods: The present study combined data from two existing studies resulting in a sample size of 46 women with AN and 56 age-matched healthy comparison (HC) women. Group differences in volume and shape of the regions of interest were examined. Within the AN group, the impact of eating disorder characteristics on volume and shape of the basal ganglia regions were also explored. Results: The shape analyses revealed inward deformations in the left caudate, right NAcc, and bilateral ventral and internus globus pallidus, and outward deformations in the right middle and posterior globus pallidus in the AN group. Conclusions: The present findings appear to fit with the theoretical models suggesting that there are alterations in the basal ganglia regions associated with habit formation and reward processing in AN. Further investigation of structural and functional connectivity of these regions in AN as well as their role in recovery would be of interest
Rank perception and self-evaluation in eating disorders
No full textObjectives Heightened sensitivity to social comparison and negative self-evaluation have been implicated in the development and maintenance of eating disorders (EDs). This study used behavioral tasks, as well as self-report measures, to examine processing of social rank-related cues and implicit self-concept in participants with EDs. Method Fifty healthy participants (HCs), 46 people with an ED, and 22 people recovered from an ED (REC) undertook an attentional bias task using social rank-related cues and an implicit self-evaluation task. In addition, they completed self-report measures of social comparison, submissive behavior, and shame. Results People with EDs showed vigilance toward social rank-related stimuli and lower implicit positive self-evaluation than HCs. Self-report data confirmed the behavioral findings and showed that people with EDs had higher levels of unfavorable social comparison, submissive behaviors, and external and internal shame than HCs. People who had recovered from an ED showed an intermediate profile between the two groups. Discussion People with EDs have heightened sensitivity to social rank-related cues and impaired self-evaluation at an automatic level of processing. Some of these biases remain in people who have recovered. Interventions which aim to remediate social threat sensitivity and negative bias about self and others might be of benefit in EDs. © 2014 Wiley Periodicals, Inc
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