1,721,010 research outputs found
Eating disorder not otherwise specified (EDNOS): profiles of those presenting at a community eating disorder service
No full textObjective: a substantial proportion of eating disorder presentations receive a DSM-IV diagnosis of eating disorder not otherwise specified (EDNOS), yet research comparing EDNOS with anorexia nervosa (AN) and bulimia nervosa (BN) is limited. The aim of this study was to further investigate EDNOS in clients at a UK Community Eating Disorder Service.Method: the Eating Disorder Examination (EDE) was used to generate DSM-IV diagnoses. Clinical profiles of EDNOS clients are compared with those of patients with AN and BN and cluster analysis used to identify subgroups based on presenting features rather than diagnosis.Results: 190 of 200 participants had a clinical eating disorder: 11 had AN, 45 had BN, 134 had EDNOS. Cluster analysis suggested four subgroups within the clinical sample: three with similar cognitive psychopathology but varied behavioural presentation, and one with less severe cognitive and behavioural features, but low mean BMI.Discussion: these results highlight the need for further investigation into EDNOS and its usefulness as a diagnosis
The clinical features of EDNOS: relationship to mood, health status and general functioning
No full textStudy purpose: Eating disorder not otherwise specified (EDNOS) remains poorly evaluated in terms of eating
disorder features and relationship to mood, health status and general functioning. This study investigated
the clinical profiles of a sample of EDNOS patients, and how they compared to patients with anorexia nervosa
(AN) and bulimia nervosa (BN).Method: The sample consisted of 178 patients. All completed the Eating Disorder Examination, Beck
Depression Inventory, Work and Social Adjustment Scale and Sf-36. ANOVAs were conducted to explore
group differences.Results: No differences were found for depression. No differences were found between BN and EDNOS on
measures of health status and general functioning. AN patients reported greater role limitations due to
physical health and experienced greater physical pain compared with BN or EDNOS patients, and reported
poorer social functioning, lower vitality and higher functional impairment compared with EDNOS patients.Conclusion: EDNOS patients are generally no less clinically impaired than those with BN. However AN
patients may be more impaired in some aspects of general functioning compared with BN or EDNOS patients
Extreme-reactions to a diagnostic interview: problems in screening for psychopathology in a non-referred sample of school children
No full textThere are currently a number of diagnostic interviews designed to assess psychopathology in children according to the DSM and ICD diagnostic systems. There is very little research about the way in which children and adolescents experience these interviews or potential problems with diagnostic interviewing. The aims of this article are to describe some extreme reactions to a diagnostic interview conducted for research purposes, review the available literature on this subject, and discuss the implications of the current findings with regard to clinical researc
An approach to sub-grouping the eating disorder population: adding attachment and coping style
No full textObjective: to investigate whether clinically meaningful sub-groups of patients can be identified by clustering eating disorder features, attachment and coping styles. Method: 165 patients completed the Eating Disorder Examination (EDE), Attachment Style Questionnaire (ASQ) and Utrecht Coping List (UCL). Cluster analysis was used to identify sub-groups across the sample. Results: four clusters were identified. Cluster one had low levels of eating disorder behaviours and the most severe attachment and coping difficulties. Cluster two had high levels of dietary restriction and exercise, and a fearful/avoidant attachment style. Cluster three had high levels of binge eating and vomiting, and few attachment and coping difficulties. Cluster four had low levels of eating disorder features and positive attachment and coping styles. Conclusions: clustering participants on the basis of eating disorder features, attachment and coping yields four sub-groups appearing to have clinical face validity
Management of child and adolescent eating disorders: the current evidence base and future directions
No full textAlthough eating disorders in children and adolescents remain a serious cause of morbidity and mortality, the evidence base for effective interventions is surprisingly weak. The adult literature is growing steadily, but this is mainly with regard to psychological therapies for bulimia nervosa and to some extent in the field of pharmacotherapy. This review summarises the recent research literature covering management in three areas, namely physical management, psychological therapies, and service issues, and identifies prognostic variables. Findings from the adult literature are presented where there is good reason to believe that these might be applied to younger patients. Evidence-based good practice recommendations from published clinical guidelines are also discussed. Suggestions for future research are made, focusing on 1) the need for trials of psychological therapies in anorexia nervosa, 2) applications of evidence-based treatments for adult bulimia nervosa to the treatment of adolescents, and 3) clarification of the benefits and costs of different service models
Reliability and validity of the child version of the Eating Disorder Examination: a preliminary investigation
No full textObjective: The Eating Disorder Examination (EDE) is a reliable and valid semistructured interview that measures the specific psychopathology of anorexia nervosa (AN) and bulimia nervosa. The current study aims to investigate the psychometric properties of the child adaptation of the EDE (ChEDE 12.0).Method: The ChEDE was administered to 15 children with AN, 15 children with other clinical eating disturbances, and two groups of 15 age-matched controls. The groups were compared using a two-sample matched groups design.Results: Alpha coefficients for each of the ChEDE subscales indicated a high degree of internal consistency, and interrater reliability was found to be high (r = .91 to r = 1.00). The subscale scores of the AN group were significantly higher than those of the other groups, whereas the other eating disturbance group did not differ from its control group.Discussion: The ChEDE differentiates children with AN from children with other forms of clinical eating disturbance and control children
Schema avoidance in bulimic and non-eating-disordered women
No full textObjective: models of bulimia lack a clear conceptualization of avoidance. This study considers the role of different domains of schema avoidance in bulimic disorders and examines the association of scores on the Young-Rygh Avoidance Inventory (YRAI) with bulimic pathology.Methods: a total of 19 bulimic and 74 comparison women completed the YRAI and a measure of bulimic psychopathology.Results: bulimics scored significantly higher than the nonclinical women did on all YRAI scales. Greater reported use of avoidance was positively associated with bulimic attitudes, but only among the comparison group. At a dimensional level, behavioral/somatic avoidance was more strongly associated with bulimic pathology than cognitive/emotional avoidance, but the same was not true when differentiating groups.Conclusions: the YRAI is a robust measure of different domains of schema avoidance in understanding bulimic psychopathology. Clinically, the YRAI might be used to guide treatment for bulimic disorder
A new approach to clustering eating disorder patients: assessing external validity and comparisons with DSM-IV diagnoses
No full textIntroduction: This study assessed the external validity of four statistically distinct clusters identified in a
sample of eating disorder patients, derived from eating disorder features, attachment and coping styles. It
also compared clusters with DSM-IV diagnoses.Methods: Eating disorder psychopathology, attachment, coping, mood, health status and general functioning
were measured in 165 patients.Results: The ‘mild eating disorder group’ reported significantly lower levels of functional impairment
compared with the ‘insecure generalised eating disorder’ group, and significantly higher levels of social
functioning, vitality and general mental health compared with the ‘passive/avoidant restrictors’ and
‘insecure generalised eating disorder’ groups. These latter groups reported significantly higher levels of
depression compared with the ‘bulimic’ and ‘mild eating disorder’ groups. Compared with DSM-IV diagnoses,
clusters were more clearly differentiated on a wide range of features, including mood and health status as
well as eating disorder features, attachment and coping.Conclusions: Findings provide preliminary support for the external validity of the clusters. Future research
might extend this work by investigating the clusters in relation to recovery, relapse and treatment response
Family physician consultation patterns indicate high risk for early-onset anorexia nervosa
No full textObjective:
There is often a delay in the recognition of early-onset anorexia nervosa. The current study aimed to determine whether there are specific patterns in the frequency and content of family physician consultations that might predict its onset.Method:
Lifetime number and type of family physician consultations were recorded for three groups: (a) an index group comprising 19 girls with anorexia nervosa, onset under 14; (b) a clinical control group comprising 19 girls with an emotional disorder; and (c) a nonclinical group comprising 19 girls with no history of mental health problems.Results:
Both clinical groups had an elevated number of consultations, particularly in the 5 years before diagnosis. The index group had a significantly higher number of eating, weight, and shape consultations (especially in the year before diagnosis), whereas the clinical control group had a greater number of psychological consultations.Conclusion:
A single consultation about eating behaviour or weight and shape concerns is a strong predictor of the subsequent emergence of anorexia nervosa
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