International Journal of Eating Disorders

doi: 10.1002/1098-108X(199505)17:4<::AID-EAT2260170401>3.0.CO;2-1pmid: N/A

Robin, Arthur L.; Siegel, Patricia T.; Moye, Anne

doi: 10.1002/1098-108X(199505)17:4<313::AID-EAT2260170402>3.0.CO;2-8pmid: 7620470

This study evaluated the impact on family relations of behavioral family systems therapy (BFST) versus ego‐oriented individual therapy (EOIT) as treatments for adolescents with anorexia nervosa. Twenty‐two adolescents meeting DSM‐III‐R anorexia nervosa criteria were randomly assigned to receive approximately 16 months of either BFST or EOIT along with a common medical and dietary regimen. BFST emphasized parental control over eating, cognitive restructuring, and problem‐solving communication training. EOIT emphasized building ego strength, adolescent autonomy, and insight. Measures included body mass index, self‐reported general and eating‐related conflict, and observed general and eating‐related communication. Both treatments produced significant reductions in negative communication and parent‐adolescent conflict, with some differences between conditions and between eating and non‐eating related conflict measures; the improvements in eating‐related conflict were maintained at a 1‐year follow‐up. The study demonstrated that structured therapies for adolescent anorexia do impact family relations, even when the family is never seen as a unit during the therapy. © 1995 by John Wiley & Sons, Inc.

Blouin, Jane; Schnarre, Kim; Carter, Jacqueline; Blouin, Arthur; Tener, Lorna; Zuro, Catherine; Barlow, Jane

doi: 10.1002/1098-108X(199505)17:4<323::AID-EAT2260170403>3.0.CO;2-2pmid: 7620471

The aim of this study was to retrospectively identify clinical variables assessed prior to treatment which were predictive of patients' dropping out versus completing a 10‐week group cognitive‐behavioral treatment program for bulimia nervosa. Following a lengthy initial assessment, 81 women meeting DSM‐III‐R criteria for bulimia nervosa (BN) were referred to one of twelve 10‐week groups of 8 to 12 patients having bulimic symptoms. The dropout rate for those meeting full DSM‐III‐R criteria for BN was found to be 28.7%. A series of seven discriminant function analyses were performed to determine whether dropouts differed from completers in terms of depression, anxiety, difficulties in trust and relating to others, bulimic symptom severity, family environment, weight history and symptom duration, and severity of bulimic cognitions. Of these, only the factor assessing difficulties trusting and relating to others was found to significantly discriminate dropouts from completers. Implications of the findings are discussed in terms of clinical and research relevance in the field of eating disorders. © 1995 by John Wiley & Sons, Inc.

Neuberger, Shira K.; Rao, Radhika; Weltzin, Theodore E.; Greeno, Catherine; Kaye, Walter H.

doi: 10.1002/1098-108X(199505)17:4<331::AID-EAT2260170404>3.0.CO;2-Zpmid: 7620472

After admission for weight restoration, restrictor anorectics (n = 17) gained significantly less weight than bulimic anorectics (n = 17) in a 30‐day period. However, these groups had similar caloric intake. Severity of illness was found to be a predictor of rate of weight gain for restrictor anorectics, but not for bulimic anorectics. © 1995 by John Wiley & Sons, Inc.

Salisbury, Juanita J.; Levine, Allen S.; Crow, Scott J.; Mitchell, James E.

doi: 10.1002/1098-108X(199505)17:4<337::AID-EAT2260170405>3.0.CO;2-Qpmid: 7620473

Patients with anorexia nervosa require refeeding to restore normal body weight. A variety of studies have examined the role of metabolic rate in the refeeding of anorectic patients. Several measurement techniques have been used to divide metabolic rate into its components: basal metabolic rate, resting energy expenditure, activity‐induced thermogenesis, and dietary‐induced thermogenesis. In anorexia nervosa patients several consistent findings are present. First, the number of kilocalories required for weight gain or weight maintenance increases as weight increases. Second, over 50% of the body mass gained in anorectic individuals represents fat tissue. Finally, both a history of bulimic symptoms and a higher premorbid body weight may lead to lower calorie requirements. These findings suggest the need for gradual increase in calories provided throughout treatment; resting energy expenditures may aid the determination of caloric requirements. © 1995 by John Wiley & Sons, Inc.

Szmukler, George I.; Young, Graeme P.; Miller, Gladys; Lichtenstein, Meir; Binns, David S.

doi: 10.1002/1098-108X(199505)17:4<347::AID-EAT2260170406>3.0.CO;2-Kpmid: 7620474

To determine the efficacy of cisapride, 10 mg three times daily, in improving gastric emptying, reducing distress during meals, and facilitating weight gain in anorexia nervosa, we conducted an 8‐week, randomized, double‐blind, placebo‐controlled trial on 29 inpatients. Measures included scintigraphic gastric emptying studies at 0, 2, 4, and 8 weeks; subjective distress during meals measured by visual analogue scales; selfrating of degree of global improvement in symptoms associated with eating at end of study; and weight measured weekly. Gastric emptying improved significantly but equally in both groups over the study period. Yet subjective measures were better in the cisapride group; they rated themselves as more hungry (p = .02) and more improved on the global measure of change in symptoms (p = .02). Even so, the cisapride group did not gain more weight. The correlation between gastric emptying and weight gain was modest (r = .30; p = .11), and between gastric emptying and the subjective measures, virtually absent. © 1995 by John Wiley & Sons, Inc.

Geretsegger, Christian; Greimel, Karoline V.; Roed, Llona S.; Hesselink, Jan M. Keppel

doi: 10.1002/1098-108X(199505)17:4<359::AID-EAT2260170407>3.0.CO;2-Cpmid: 7620475

Seventeen women who met the criteria for bulimia nervosa (DSM‐III‐R) were treated for 4 weeks in an open trial with ipsapirone, a partial 5‐HT1A agonist. Bulimic symptoms diminished in 66.6% of the patients after only 1 week of treatment, 93.3% showed a reduction of more than 50% of weekly binge eating attacks after 4 weeks. The mean frequency of binges was reduced by 81% at endpoint. Ipsapirone was well tolerated. © 1995 by John Wiley & Sons, Inc.

Tiller, Jane; Schmidt, Ulrike; Ali, Shireen; Treasure, Janet

doi: 10.1002/1098-108X(199505)17:4<365::AID-EAT2260170408>3.0.CO;2-Apmid: 7620476

The level and direction of hostility in patients with bulimia nervosa, anorexia nervosa and a comparison group were measured using the Hostility and Direction of Hostility Questionnaire. A semistructured interview developed by Harris, Brown, and Bifulco (Psychological Medicine, 16, 641‐659, 1986) was used to assess childhood care to examine whether a link exists between childhood exposure to aggression or parental neglect and adult hostility. Patients with eating disorders had significantly higher hostility levels and were significantly more intropunitive than the comparison group. Patients with bulimia nervosa were significantly more intropunitive than the comparison group. Patients with bulimia nervosa were significantly more hostile than patients with anorexia nervosa. Anorexia nervosa patients were more likely to direct hostility inwardly, rather than outwardly, when compared with bulimia nervosa patients. Impulsivity was associated with extrapunitiveness whereas intropunitiveness was associated with depression. Although some measures of poor childhood care correlated with adult hostility levels no clear pattern emerged. © 1995 by John Wiley & Sons, Inc.

Valdiserri, Susan; Kihlstrom, John F.

doi: 10.1002/1098-108X(199505)17:4<373::AID-EAT2260170409>3.0.CO;2-6pmid: 7620477

A total of 656 male and female college students completed the Eating Disorder Inventory (EDI) and a modified version of the Dissociative Experiences Scale (M‐DES). There were significant correlations between dissociative experiences and each of the EDI subscales, especially for women. Even among women, however, dissociation was more strongly related to aspects of ego dysfunction than to abnormal eating per se. This finding sets limits on the hypothesized association between dissociative disorder and eating disorder. © 1995 by John Wiley & Sons, Inc.

Drewnowski, Adam; Kurth, Candace L.; Krahn, Dean D.

doi: 10.1002/1098-108X(199505)17:4<381::AID-EAT2260170410>3.0.CO;2-Vpmid: 7620478

This cross‐sectional survey study examined body image, dieting and exercise variables, and steroid use in 2,088 high‐school graduates aged 18 years. In contrast to women, more men wished to gain (46%) rather than lose weight (32%). Men who wished to gain weight were more satisfied with their body shape, showed no fear of fatness, and dieted and exercised less frequently than did men who wished to lose weight. The prevalence of dieting was low (4%), even among men who wished to lose weight (9%), and physical exercise was more likely to be used for both weight loss and weight gain. Contrary to expectations, anabolic steroid use was rare (0.6%) and was not associated with a desire for weight gain. Steroid users were more likely to engage in running and swimming than football. The data did not support the notion that anabolic steroid use is widespread among high‐school males. © 1995 by John Wiley & Sons, Inc.