Improvement and Recovery from Eating Disorders: A Patient Perspective

This study presents a patient perspective on improvement and recovery from eating disorders. Forty-eight women recruited from patient organizations and a university eating disorder unit participated in the study. Participants completed standard questionnaires and a qualitative interview. "A wish to change," professional treatment, nonprofessional care, and important persons in the women's lives were identified as important recovery factors. Recovery included improved acceptance of oneself, interpersonal relations, problem solving, and body satisfaction, which was not entirely dependent on symptom absence. The patient perspective concurred with clinical reasoning about recovery.     

Retrospective Experiences of First-Episode Psychosis Treatment Under Open Dialogue-Based Services: A Qualitative Study

Community Mental Health Journal - Open Dialogue (OD) is an integrated approach to mental health care, which has demonstrated promising outcomes in the treatment of first-episode psychosis (FEP) in...     

Expectations and Experiences of Treatment in Eating Disorders

The present study presents the development of a self-report measure of treatment expectations and experiences for eating disorder patients. Patients participating in a Swedish multi-center study ( N = 461) who had been followed-up 6 months after initial assessment were examined on the Eating Disorder Patient's Expectations and Experiences of Treatment Questionnaire (EDPEX). The scale consists of 14 items comprising three subscales (Support, Control, and Insight). Separate versions were used for measuring expectations and subsequent experiences of treatment interventions. Inter-item reliability was satisfactory, and principal components analysis reflected the scale structure. When treatment experiences and change in eating disorder and psychiatric symptomatology were used to predict treatment satisfaction, experiences of support alone predicted 22% of the variance in treatment satisfaction one year later. The EDPEX can be a useful and economical measure for assessing treatment expectations and experiences among eating disorder patients.     

Disordered Eating and Gender Identity Disorder: A Qualitative Study

The association between disordered eating and gender identity was examined in a sample of 20 (11 female-to-male, 9 male-to-female) transgender Finnish adults, aged 21–62 years. Using semi-structured interviews, participants' own understanding of the underlying causes of their disordered eating was analyzed, as well as the effect of gender reassignment on eating behaviors and cognitions. A majority of the participants reported current or past disordered eating. Participants most frequently described strive for thinness as an attempt to suppress features of one's biological gender, or accentuate features of one's desired gender. Gender reassignment was primarily perceived as alleviating symptoms of disordered eating.     

Barriers to Help-Seeking in Young Women With Eating Disorders: A Qualitative Exploration in a Longitudinal Community Survey

Few with eating disorders (EDs) access evidence-based treatments. We conducted a prospective exploration of help-seeking by 57 community women with bulimic-type EDs using the Framework approach of familiarization, identifying themes, indexing, charting and mapping and interpretation. The mean age of the sample was 33 years. Results found women sought help for concerns regarding perceived (over) weight rather than for eating, although many women would have welcomed questions from professionals regarding eating behaviours. Empathy, providing information and hope were considered important features of health professionals to provide a positive experience of help-seeking. Specific personal barriers to treatment included low motivation, fear of stigma, and cost. Greater clinician and community awareness of and action on these issues would likely help close “the gap” for effective help-seeking by those with EDs.     

Eating Disorders: A Means for Seeking Approval?

This study explored the predictive relationship of specific eating disorder symptomology including drive for thinness, bulimia, body dissatisfaction, ineffectiveness, perfectionism, interpersonal distrust, low interoceptive awareness, and maturity fears with the need for approval. A total of 495 college students completed an 84-item questionnaire phus demographic information. The questionnaire consisted of the Revised Martin-Larsen Approval Motivation Scale (MLAM) and the Eating Disorder Inventory. Results indicated that scores on various Eating Disorder subscales had significant predictive effects on approval-motivation. Gender differences were also found to exist across the variables examined. Females were found to have a significant relationship to approval motivation in the area of bulimia and males showed a significant relationship in the areas of interpersonal distrust and perfectionism.     

Prevention of Eating Disorders Among Minority Youth: A Matched-Sample Repeated Measures Study

The purpose of this study was to examine ethnic differences in primary prevention programs for eating disorders in young girls. In order to address the dearth of research in this area, this study examined the comparative response to an eating disorder prevention program on fifth-grade minority and White females. Pre- and post-test data were collected from 10 groups participating in the prevention program for a total of 50 girls. Minority participants and White participants were then matched based on Body Mass Index (BMI) and socioeconomic status in order to examine ethnic differences in group effectiveness. Findings indicated that minority and White participants were equally responsive to the prevention program.     

Eating Disorders: A Disorder of In and Out

The coexistence of a traumatic past and the development of an eating disorder is corroborated by clinicians and researchers. This article will discuss the author's concept of "the disorder of in and out" which is believed to describe the resulting core pathology: the individual does not know what to take into their lives and what to keep out of it, which is believed to be expressed metaphorically via symptoms. Treatment approaches will be explicated utilizing this perspective. Symptom choice, trauma, attachment and dissociation theories will be discussed with respect to the concept of a disorder of in and out.     

Peer-Led and Professional-Led Group Interventions for People with Co-occurring Disorders: A Qualitative Study

This pilot study evaluated the experience of people with co-occurring disorders (mental illness and addiction) in relation to peer-led and professional-led group interventions. The study used a qualitative (phenomenological) approach to evaluate the experience of a convenience sample of 6 individuals with co-occurring disorders who participated in up to 8 sessions each of both peer-led and professional-led group interventions (with a similar rate of attendance in both groups). The semi-structured interview data were coded and thematically analyzed. We found 5 themes within and across the 2 interventions. In both groups, participants experienced a positive environment and personal growth, and learned, albeit different things. They were more comfortable in the peer-led group and acquired more knowledge and skills in the professional-led group. Offering both peer-led and professional-led group interventions to people with co-occurring disorders may be better than offering either alone     

Access to Care for Autism-Related Services

This paper identifies family characteristics associated with use of autism-related services. A telephone or in-person survey was completed during 2003–2005 by 383 North Carolina families with a child 11 years old or younger with ASD. Access to care is limited for racial and ethnic minority families, with low parental education, living in nonmetropolitan areas, and not following a major treatment approach. Service use is more likely when parents have higher stress. Families use a broad array of services; the mix varies with child ASD diagnosis and age group. Disparities in service use associated with race, residence and education point to the need to develop policy, practice and family-level interventions that can address barriers to services for children with ASD.     

Impact of Coaching Style on Vulnerability for Eating Disorders: An Analog Study

Abstract

This analog study examined the impact of coaching style on athletes' vulnerability for eating problems using a 2 (positive vs. negative coaching vignette) by 2 (male vs. female) factorial experiment with the following dependent variables: mood, dieting, fear of fat. and body image anxiety. One hundred ten college students were randomly assigned to vignette conditions. The negative vignette portrayed a coach who was performance-centered and focused on weight in a threatening manner. The coach in the positive vignette was also focused on weight, but in a person centered and caring manner. It was hypothesized females compared to males would react more pathologically to the negative versus positive vignette condition. Contrary to expectations, gender failed to interact with vignette condition. However, participants in the negative vignette exhibited higher instances of dieting, body image anxiety, and fear of fat. This research implies coaching style could create an increased vulnerability for body image and eating problems in student athletes.     

Impact of Coaching Style on Vulnerability for Eating Disorders: An Analog Study

This analog study examined the impact of coaching style on athletes' vulnerability for eating problems using a 2 (positive vs. negative coaching vignette) by 2 (male vs. female) factorial experiment with the following dependent variables: mood, dieting, fear of fat. and body image anxiety. One hundred ten college students were randomly assigned to vignette conditions. The negative vignette portrayed a coach who was performance-centered and focused on weight in a threatening manner. The coach in the positive vignette was also focused on weight, but in a person centered and caring manner. It was hypothesized females compared to males would react more pathologically to the negative versus positive vignette condition. Contrary to expectations, gender failed to interact with vignette condition. However, participants in the negative vignette exhibited higher instances of dieting, body image anxiety, and fear of fat. This research implies coaching style could create an increased vulnerability for body image and eating problems in student athletes.     

Middle School Primary Prevention Program for Eating Disorders: A Controlled Study with a Twelve-Month Follow-Up

The aim of this pilot study was to evaluate the efficacy of a new school-based eating disorder prevention program designed to reduce dietary restraint and the level of preoccupation with regard to shape and weight. One hundred and six (61 females and 45 males) 11 to 12-year-old students were evaluated, 55 of whom participated in the program (experimental group). An additional 51 students formed the control group. The program met for six sessions, two hours per session. After six months, the experimental group received two booster sessions of two hours in two consecutive weeks. Outcome measures included the Eating Disorder ExaminationQuestionnaire (EDE-Q), the children's version of the Eating Attitudes Test (EAT), the Rosenberg Self-Esteem Scale (RSES), and a Knowledge Questionnaire (KQ) devised by the authors of the program. The questionnaires were administered in both the experimental and control groups, one week before the intervention, one week afterwards, and at six-month and 12-month follow-ups. Unlike a previous school-based eating disorder prevention program, in the experimental group both an increase in knowledge and a decrease in some attitudes were maintained at 12-month follow-up (Eating Concerns EDE-Q scores). Although more intensive interventions seem necessary to modify shape and weight concern and self-esteem, these findings suggest that the intervention had been useful since it led to both an increase in knowledge and a decrease in some dysfunctional eating attitudes.     

A Qualitative Study of Binge Eating and Obesity From an Addiction Perspective

The purpose of this study was to explore how obese women with and without binge eating disorder (BED) experience overeating in relation to the DSM-5 symptoms of addiction. Findings from this study demonstrate that food addiction can occur in obese individuals with and without BED. It is important that health care professionals identify individuals who may require a specific treatment approach that incorporates techniques used in the treatment of addictions.     

Group Parent Training: A Novel Approach for the Treatment of Eating Disorders

This paper describes the rationale, development, and implementation of a group parent training program designed to assist caregivers in the management of their child's eating disorder while facilitating the development of a healthy home environment for sustained change. The content of this program instructs caregivers in disorder management and capitalizes on caregivers as role models of adaptive behavior. Strategies are provided to address acute disorder management, features of caregivers that may impede task implementation, and environmental and attitudinal changes. The group format enhances social support, accountability, and self-efficacy. A preliminary qualitative evaluation and future directions are described to assist healthcare professionals in better meeting the needs of caregivers of these disorders.     

Searching for Answers: Eating Disorders and Self-Harm Behavior

Abstract

During the past two decades, hundreds of eating disorder outcome studies and dozens of review articles have been published. It is difficult for practitioners, and even researchers, to find time to read all of these materials. To help practitioners and, researchers more easily become current about eating disorder treatment research. we have distilled and summarized the conclusions of 23 eating disorder treatment outcome review articles that have been published since 1987. We also present some implications for practice and research.