Disorders - Eating Disorders
Stiles-Shields, Colleen, Hoste, Renee Rienecke, Doyle, Peter M., le Grange, Daniel
This review focuses on the use of family-based treatment (FBT)
for adolescents with eating disorders, including anorexia nervosa (AN) and bulimia nervosa (BN). AN and BN are serious disorders with significant
psychiatric and medical morbidity. Data support the use of family treatments for adolescents with eating disorders. Developed at the Maudsley
Hospital, FBT is a theoretically agnostic approach that externalizes the illness from the patient and empowers families to actively work to bring
about recovery in their relative with an eating disorder. FBT appears to be an effective treatment for adolescents with AN and support is developing
for the treatment of adolescents with BN. Manual development is currently underway for the implementation of FBT for young adults with eating
disorders, overweight adolescents, and those with subsyndromal AN. Further research is needed to determine the effectiveness of FBT with other
populations. In this review, we will provide a critical overview of the literature by focusing upon empirical findings regarding FBT, with particular
emphasis on studies conducted with adolescents.;
Reviews on
Recent Clinical Trials, 7(2) : 133-140
- Year: 2012
- Problem: Eating Disorders
(any), Anorexia Nervosa, Bulimia Nervosa
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Family therapy
Onnis, L., Barbara, E., Bernardini, M., Caggese, A., Di Giacomo, S., Giambartolomei,
A., Leonelli, A., Mule, A. M., Nicoletti, P. G., Vietri, A.
This article presents the results of a
broader clinical research into the effectiveness of integrated treatments in teenage eating disorders, carried out at the Complex Operative Unit of
Psychotherapy (Unita Operativa Complessa or U.O.C.) of the Department of Psychiatric Sciences and Psychological Medicine in collaboration with the
Department of Neuropsychiatric Science for Child Development (Dipartimento di Scienze Neuropsichiatriche dell'Eta Evolutiva), both at the \"La
Sapienza\" University of Rome. The hypothesis of this research project is that in diagnosticable situations such as anorexia or bulimia, an
integrated and multidisciplinary treatment, which combines medical-nutritional interventions and family psychotherapy, allows better results than a
single kind of treatment, which is the usual medical-nutritional intervention supported by psychiatric counselling. Twenty-eight cases (16 of bulimia
and 12 of anorexia) were selected and then subdivided, with a randomized distribution, into two (experimental and control) homogeneous groups of 14
patients. The grouping variables were the diagnosis, the disorder's seriousness and duration, BMI, gender, age, family composition and social
status. The variables which have been examined in this article are the clinical parameters, which were valuated in accordance with the DSM IV-TR
criteria, and relational parameters which were explored through the use of the W.F.T. Test (Wiltwyck Family Tasks). These parameters were tested at
beginning as well as at the end of the therapies, in both the experimental group and the control group. Statistical analysis has shown that the
experimental group, which was followed with the integrated treatment, experienced a significant improvement of the parameters as related to
dysfunctional family interaction modalities, and that this improvement was correlated to the positive evolution of the clinical parameters. This
improvement was not present or not of the same degree in the control group. The results, moreover, demonstrate the effectiveness of an integrated
systemic treatment based on a complex approach compared to a reductionist approach. (copyright)2012, Editrice Kurtis.
Eating & Weight Disorders, 17(1) : e36-e48
- Year: 2012
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Family therapy, Other Psychological Interventions, Dietary advice, dietary change
Ramirez, A. L., Perez, M., Taylor, A.
The purpose of the
current study was to investigate a new dissonance-based prevention program that is based on the dual pathway model of eating disorders within the
context of an individual's romantic relationship. A total of 209 dating couples participated in a couple-based prevention program or an assessment-
only condition and completed measures of body dissatisfaction, thin-ideal internalization, disordered eating, negative affect, and relationship
satisfaction at two time points (approximately one week apart) and approximately half of the sample completed 1-month follow-up measures. The
prevention program significantly reduced several key risk factors for eating disorders such as environmental pressures to be thin, internalization of
the thin and athletic ideals, state body dissatisfaction, and actual-ideal body discrepancy. Initial support was found for the inclusion of couples
in eating disorder prevention programs as a successful way of addressing the thin ideal and its detrimental effects for women. (copyright) 2012
Elsevier Ltd.
Body Image, 9(3) : 324-333
- Year: 2012
- Problem: Eating Disorders
(any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Cognitive dissonance
therapy
Jacobi, Corinna, Volker, Ulrike, Trockel, Mickey T., Taylor, Craig Barr
Background: Women reporting
initial eating disorder (ED) symptoms are at highest risk for the development of an eating disorder. Preventive interventions should, therefore, be
specifically tailored for this subgroup.; Aims: To adapt and evaluate the effects of the Internet-based prevention program \"Student Bodies™\" for
women with symptoms of disordered eating and/or subthreshold eating disorder (ED) syndromes.; Method: 126 women, reporting subthreshold ED symptoms
(high weight and shape concerns and below threshold bingeing, purging, chronic dieting or several of these symptoms) were randomly assigned to a
Student Bodies™+ (SB+) intervention or a wait-list control group and assessed at pre-intervention, post-intervention, and 6-month follow-up.
\"Student Bodies™\" was adapted to be suitable for subthreshold EDs. Main outcome measures were attitudes and symptoms of disordered eating. Pre-
follow-up data were analyzed by ANCOVAS with mixed effects.; Results: At 6-month follow-up, compared to participants in the control group,
participants in the intervention group showed significantly greater improvements on ED-related attitudes. Intervention participants also showed 67%
(95% CI = 20-87%) greater reductions in combined rates of subjective and objective binges, and 86% (95% CI = 63-95%) greater reduction in purging
episodes. Also, the rates of participants abstinent from all symptoms of disordered eating (restrictive eating, binge eating and any compensatory
behavior) were significantly higher in the intervention group (45.1% vs. 26.9%). Post-hoc subgroup analyses revealed that for participants with binge
eating the effect on EDE-Q scores was larger than in the pure restricting subgroup.; Conclusion: The adapted \"SB+\" program represents an effective
intervention for women with subthreshold EDs of the binge eating subtype.; Copyright © 2011 Elsevier Ltd. All rights reserved.
Behaviour Research & Therapy, 50(2) : 93-
99
- Year: 2012
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Self-help, Technology, interventions delivered using technology (e.g. online, SMS)
Meule, Adrian, Freund, Rebecca, Skirde, Ann Kathrin, Vogele, Claus, Kubler, Andrea
Heart rate variability (HRV) biofeedback has been reported to increase HRV while decreasing symptoms in patients with mental disorders.
In addition, associations between low HRV and lowered self-regulation were found in non-clinical samples, e.g., in individuals with strong chocolate
cravings or unsuccessful dieting. The current study aimed at decreasing food cravings with HRV-biofeedback in individuals frequently experiencing
such cravings. Participants (N = 56) with strong or low food cravings associated with a lack of control over eating were selected from the local
community. Half of the participants with strong cravings (craving-biofeedback; n = 14) performed 12 sessions of HRV-biofeedback while the other half
(craving-control; n = 14) and a group with low cravings (non-craving-control; n = 28) received no intervention. Subjective food cravings related to a
lack of control over eating decreased from pre- to post-measurement in the craving-biofeedback group, but remained constant in the control groups.
Moreover, only the craving-biofeedback group showed a decrease in eating and weight concerns. Although HRV-biofeedback was successful in reducing
food cravings, this change was not accompanied by an increase in HRV. Instead, HRV decreased in the craving-control group. This study provides
preliminary evidence that HRV-biofeedback could be beneficial for attenuating dysfunctional eating behavior although specific mechanisms remain to be
elucidated.;
Applied Psychophysiology & Biofeedback, 37(4) : 241-251
- Year: 2012
- Problem: Eating Disorders
(any)
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Biofeedback, neurofeedback, audio/video feedback
House, J., Schmidt, U., Craig, M., Landau, S., Simic, M., Nicholls, D., Hugo, P., Berelowitz, M., Eisler, I.
Objective: To explore the role of specialist outpatient eating disorders services and investigate how direct access to
these affects rates of referral, admissions for inpatient treatment, and continuity of care. Method: Services beyond primary care in Greater London
retrospectively identified adolescents who presented with an eating disorder over a 2-year period. Data concerning service use were collected from
clinical casenotes. Results: In areas where specialist outpatient services were available, 2-3 times more cases were identified than in areas without
such services. Where initial outpatient treatment was in specialist rather than nonspecialist services, there was a significantly lower rate of
admission for inpatient treatment and considerably higher consistency of care. Discussion: Developing specialist outpatient services with direct
access from primary care is likely to lead to improvements in treatment and reduce overall costs. (copyright) 2012 by Wiley Periodicals, Inc. (Int J
Eat Disord 2012) Copyright (copyright) 2012 Wiley Periodicals, Inc.
International Journal of Eating Disorders, 45(8) : 949-
956
- Year: 2012
- Problem: Eating Disorders
(any)
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Other service delivery and improvement
interventions
Boothroyd, L. G., Tovee, M. J., Pollet, T. V.
Systematic differences between populations in their
preferences for body size may arise as a result of an adaptive 'prepared learning' mechanism, whereby cues to health or status in the local
population are internalized and affect body preferences. Alternatively, differences between populations may reflect their 'visual diet' as a
cognitive byproduct of mere exposure. Here we test the relative importance of these two explanations for variation in body preferences. Two studies
were conducted where female observers were exposed to pictures of high or low BMI women which were either aspirational (healthy, attractive models in
high status clothes) or non-aspirational (eating disordered patients in grey leotards), or to combinations thereof, in order to manipulate their
body-weight preferences which were tested at baseline and at post-test. Overall, results showed good support for visual diet effects (seeing a string
of small or large bodies resulted in a change from pre- to post-test whether the bodies were aspirational or not) and also some support for the
associative learning explanation (exposure to aspirational images of overweight women induced a towards preferring larger bodies, even when
accompanied by equal exposure to lower weight bodies in the non-aspirational category). Thus, both influences may act in parallel. (copyright) 2012
Boothroyd et al.
PLoS
ONE, 7(11) :
- Year: 2012
- Problem: Eating Disorders
(any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Atkinson, Melissa J., Wade, Tracey
D.
Objective: To investigate engagement in metacognitive acceptance and
subsequent efficacy with respect to decreasing 2 risk factors for disordered eating, body dissatisfaction (BD), and negative affect (NA).; Method: In
a pilot experiment, 20 female undergraduates (Mage = 24.35, SD = 9.79) underwent a BD induction procedure, received acceptance training using brief
written instructions, and were then assessed on engagement in the technique. In a second experiment in which acceptance training was enhanced through
the use of video format and a guided experiential exercise, 80 female undergraduates (mean age = 23.59, SD = 8.98) were randomized to an acceptance
or control group following the same BD induction. Outcome measures were taken at baseline, postinduction, and posttreatment and consisted of separate
visual analogue scales for weight and appearance satisfaction and the NA subscale of the Positive and Negative Affect Scale. Baseline assessments
included the Eating Disorder Inventory-BD, Difficulties in Emotion Regulation Scale, Ways of Coping Questionnaire, and the Five Facet Mindfulness
Questionnaire.; Results: Enhanced training significantly increased engagement in acceptance. Nonengagement was associated with NA, emotion regulation
difficulties, and avoidant coping. Acceptance training significantly increased weight and appearance satisfaction and reduced NA relative to control,
with no significant differences between those who did and did not engage. Intervention effects were moderated by mindfulness, emotion regulation
difficulty, and avoidant coping.; Conclusions: Findings provide clarification regarding engagement and lend further support for the utility of
acceptance, with particular benefit identified for those \"at risk\" for emotion regulation difficulty.;
Journal of
Consulting & Clinical Psychology, 80(3) : 416-425
- Year: 2012
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Beintner, Ina, Jacobi, Corinna, Taylor, Craig Barr
A cross-cultural comparison of a cognitive-behavioural, Internet-based, 8-week prevention programme
for eating disorders (StudentBodies™) evaluated in the USA and in Germany was performed. Six US and four German randomized controlled trials with a
total (N) of 990 female high school and college students were included in the review. Two of the US and two of the German trials explicitly addressed
high risk samples in a selective prevention approach. Effect sizes for main outcomes (disordered eating, weight and shape concerns) were calculated
at postintervention and at follow-up. The intervention was associated with moderate improvements in eating disorder-related attitudes, especially
reductions of negative body image and the desire to be thin. The reported effects remained significant at follow-up. No clear differences between US
and German samples could be found on any of the outcome measures at postintervention. In conclusion, StudentBodies™ seems equally suitable and
effective for American and German students.; Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.
European Eating Disorders Review, 20(1) : 1-
8
- Year: 2012
- Problem: Eating Disorders
(any)
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Technology, interventions delivered using technology (e.g. online, SMS)
Becker, Carolyn Black, McDaniel, Leda, Bull,
Stephanie, Powell, Marc, McIntyre, Kevin
Female athletes are at least as at risk as other women for
eating disorders (EDs) and at risk for the female athlete triad (i.e., inadequate energy availability, menstrual disorders, and osteoporosis). This
study investigated whether two evidence-based programs appear promising for future study if modified to address the unique needs of female athletes.
Athletes were randomly assigned to athlete-modified dissonance prevention or healthy weight intervention (AM-HWI). ED risk factors were assessed
pre/post-treatment, and 6-week and 1-year follow-up. Results (analyzed sample, N=157) indicated that both interventions reduced thin-ideal
internalization, dietary restraint, bulimic pathology, shape and weight concern, and negative affect at 6 weeks, and bulimic pathology, shape
concern, and negative affect at 1 year. Unexpectedly we observed an increase in students spontaneously seeking medical consultation for the triad.
Qualitative results suggested that AM-HWI may be more preferred by athletes.; Copyright © 2011 Elsevier Ltd. All rights reserved.
Body
Image, 9(1) : 31-42
- Year: 2012
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Cognitive dissonance
therapy, Dietary advice, dietary change
Jauregui Lobera, I., Bolanos Rios, P.
Introduction and objective: Research conducted to date into the primary prevention of eating disorders has
mainly considered the provision of information regarding risk factors. Consequently, there is a need to develop new methods that go a step further,
promoting a change in attitudes and behaviour in the target population. The main objective of this study was to compare two types of intervention:
one based on this model and the other following the traditional approach of providing information. The ultimate aim was to implement a prevention
program that reduces the risk factors and boosts the protection factors that have been empirically shown to be related to ED. Materials and methods:
The research design was prospective and observational, with measurement of an active intervention (Intervention Group) and control (Control Group).
The sample comprised 371 students (secondary-level and high-school), 174 girls and 197 boys, who was divided into twelve work groups, six for the
Intervention Group, and six for the Control Group. Regarding the nutritional intake, all participants were instructed by a nutritionist on how to
complete a 3-day food record (inclusive of beverages) covering two weekdays and one weekend day.Written and verbal guidelines were provided for the
estimation of food portions. As part of the instructional session, and in order to check their understanding, participants were asked to describe the
portions used and the food preparation details for a minimum of two prior meals. All participants were encouraged to depict typical food consumption.
A research nutritionist reviewed the completed food records for clarification of portions and food preparation. Nutrient intakes were calculated from
the 3-day food records by using the calculation program of the Centre for Advanced Studies in Nutrition and Dietetics (CESNID) of the University of
Barcelona. On the basis of previous research that has indicated the need for preventive intervention to take into account recognised risk and
protective factors, with regards to nutritional aspects the degree to which eating habits followed the Mediterranean diet, according to the
recommendations of the Spanish Society for Community Nutrition, for the age groups considered, was assessed. Results: There was a considerable post-
intervention improvement in the Intervention Group in terms of the intake of MUFA (F=7.60, P<0.01, (eta)2 partial=0.03), PUFA (F=7.56, P<0.01, (eta)2
partial=0.03), vitamin B12 (F=30.41, P<0.01, (eta)2 partial=0.10), vitamin C (F=5,025, P<0.01, (eta)2 partial=0.03), vitamin E (F=11.32, P<0.01,
(eta)2 partial=0.05) and vitamin A (F=3.92, P<0.05, (eta)2 partial=0.01). In the Control Group there were no significant differences in the intake of
either macro- or micronutrients. Confirming previous research, better outcomes were obtained when intervening with females. Conclusion: The present
study shows that in the primary prevention of eating disorders, better outcomes are achieved by new models, which target the attitudes and behaviour
of adolescents rather than focusing solely on the provision of risk information to raise awareness.
International Journal of
Obesity, 35 : S156
- Year: 2011
- Problem: Eating Disorders
(any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Dietary advice, dietary change
Gonzalez,
M.
Objective: The
present study aims to evaluate the long-term effects of a school-based prevention programme administered to adolescents; the purpose of the said
programme was to reduce disordered eating attitudes and sociocultural influences on the internalisation of the aesthetical body ideal. Methods: A
total of 254 girls and 189 boys were assigned to a control (n = 201) or to two experimental conditions: media literacy programme (n = 143) and media
literacy plus nutrition awareness programme (n = 99). Pretest, post-test (1 month later) and 7-month and 30-month follow-up measurements were taken
using the Eating Attitudes Test (EAT-40) and the questionnaire on influences of aesthetic body ideal-26/cuestionario de influencias del modelo
estetico corporal (CIMEC-26). Linear mixed-model analyses were conducted with a 2 x 3 x 3 ANOVA (sex x group x phase), adjusted by the baseline
level. Results: The participants from both prevention programmes scored lower than the participants in the control group at follow-up assessments on
EAT-40 and CIMEC-26 scores. Discussion: Both media literacy-based programmes can be effective interventions reducing long-term self-reported
disordered eating attitudes and internalisation of the aesthetic body ideal in a universal mixed-sex school-going adolescent population. Copyright
(copyright) 2011 John Wiley & Sons, Ltd and Eating Disorders Association.
European Eating
Disorders Review, 19(4) : 349-356
- Year: 2011
- Problem: Eating Disorders
(any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Other Psychological Interventions, Dietary advice, dietary change