Questions & Answers

Borderline personality disorder (BPD) is an Axis II disorder that is characterized by an intact façade, longstanding self-regulation difficulties and self-harm behavior, and unstable interpersonal relationships and mood. According to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV; American Psychiatric Association, 1994 American Psychiatric Association. 1994. Diagnostic and statistical manual of mental disorders, Washington, DC: Author..  [Google Scholar]), the prevalence of BPD in the general population is around 2%. The symptoms of the disorder appear to be influenced by gender. Despite defined diagnostic criteria, BPD tends to have polymorphic clinical presentations with both multiple psychological and somatic symptoms. The etiology of BPD appears to be related to genetic predisposition, early developmental trauma, and biparental failure, although other contributory factors may be involved. We discuss, through the use of several models, the possible relationships between BPD and eating disorders.     

Questions & Answers

Are there differences in prevalence and predictors of eating disturbances among adult women (age 30+) from diverse cultural backgrounds? Most research has explored these issues with young age groups, although the results may also be relevant to adults. Fourteen community-based studies with culturally diverse samples are examined. A majority of studies (70%) reveals no significant group differences in prevalence rates. In contrast, significantly different clinical predictors emerge from multivariate analyses despite groups having similar frequency rates. Collectively, findings offer a complex, sometimes contradictory and inconclusive picture. Additional research is warranted for developing evidence-based interventions sensitive to adults from diverse cultural traditions.     

Questions & Answers: Integrating Academics in the Context of Eating Disorder Treatment

Abstract

My Sister's Bones, by Cathi Hanauer, New York: Bantam Doubleday, 1996, 272 pages, $10.95 (paper).

Wasted: A Memoir of Anorexia and Bulimia, by Marya Hornbacher, New York: HarperCollins, 1998, 298 pages, $23.00.

Women Who Hurt Themselves: A Book of Hope and Understanding, by Dusty Miller, New York: BasicBooks, 1994, 280 pages, $22.00.

Trauma, Dissociation, and Impulse Dyscontrol in Eating Disorders, by Johan Vanderlinden and Walter Vandereycken, Philadelphia, PA: Brun-ner/Mazel, 1997, 228 pages, $28.95.

Good Enough, by Cynthia Nappa Bitter, New York: Hope Lines, 1998, 293 pages, $14.95 (paper)     

Questions and Answers

Abstract

As a therapist using a cognitive-behavioral approach to treating eating disorders, I devote a significant part of my work to changing irrational ideas that perpetuate the disordered eating and related behaviors. Typically. part of each session is devoted to helping the patient recognize her irrational thoughts and encouraging her to substitute more realistic ideas. Like many cognitive-behavioral therapists (e.g., Fairburn, 1985, Hsu et al., 1991), I use cognitive restructuring techniques, such as asking questions, encouraging hypothesis testing, and offering information, that counter irrational beliefs about food and weight. One problem I have encountered with this approach is that frequent repetition may be required. Issues such as body image, dieting, emotional coping, and self-esteem reemerge in almost every session. Yet I become uncomfortable if I feel that I am repeating the same cognitive restructuring techniques too often. As a partial solution to this problem, I find that the following analogies and comparisons are helpful. They make it easier for the patient to identify her own thought patterns and to recognize the illogical assumptions in these thoughts. As therapy progresses they can serve as a shorthand that reduces the necessity for didactic discussions about irrational thinking.     

Disease-Modifying Therapies for Alzheimer’s Disease: More Questions than Answers

Scientific advances over the last four decades have steadily infused the Alzheimer’s disease (AD) field with great optimism that therapies targeting Aβ, amyloid, tau, and innate immune activation states in the brain would provide disease modification. Unfortunately, this optimistic scenario has not yet played out. Though a recent approval of the anti-Aβ aggregate binding antibody, Aduhelm (aducanumab), as a “disease-modifying therapy for AD” is viewed by some as a breakthrough, many remain unconvinced by the data underlying this approval. Collectively, we have not succeeded in changing AD from a largely untreatable, inevitable, and incurable disease to a treatable, preventable, and curable one. Here, I will review the major foci of the AD “disease-modifying” therapeutic pipeline and some of the “open questions” that remain in terms of these therapeutic approaches. I will conclude the review by discussing how we, as a field, might adjust our approach, learning from our past failures to ensure future success.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13311-022-01201-2.