Do different psychopathological pathways into eating disorder necessitate different therapeutic goals and/or approaches?

One of the goals of psychotherapy with bulimia patients is identification of the functions of the eating disorder in their lives. Thus, as in any psychotherapeutic approach, the therapist should facilitate the patient’s disclosure of his or her experience of living with bulimia. Talking about one’s dysphoric experiences and, particularly in the case of bulimia, symptoms and experiences that commonly deprive people with bulimia of dignity, constitutes an emotional challenge for the patient and an equally challenging interactional task for the therapist. Using the example of one therapy session with a female bulimia patient, we examine how the therapist and the patient interactionally engage in co-constructing the patient’s expertise – involving epistemics of experience as well as epistemics of expertise – concerning the illness in the interactional here-and-now. Applying tools and insights from discourse and conversation analysis, we examine the sequences in which the patient shifts the topical focus from a general observation concerning bulimia to her personal experience, to be further pursued interactionally by the therapist. We also discuss how the therapist downgrades her epistemic position and (concurrently) foregrounds and bolsters the patient’s voice as expert to accomplish the session’s therapeutic goals.

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Abstract #813: A Case of Hypogonadism in a Young Man with an Eating Disorder

Endocrine Practice ◽

10.1016/s1530-891x(20)42738-7 ◽

2015 ◽

Vol 21 ◽

pp. 154

Author(s):

Bert Bieler ◽

Farah Morgan

Keyword(s):

Eating Disorder

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Klassifikation von Essstörungen im Zuge von DSM-V mit besonderem Fokus auf der Diagnostik von Essanfällen bei der Binge-Eating-Störung

Zeitschrift für Psychiatrie Psychologie und Psychotherapie ◽

10.1024/1661-4747/a000081 ◽

2011 ◽

Vol 59 (4) ◽

pp. 267-274 ◽

Cited By ~ 1

Author(s):

Anja Hilbert

Keyword(s):

Eating Disorder ◽

Binge Eating ◽

Binge Eating Disorder ◽

Klinische Relevanz ◽

Dsm V

Zusammenfassung.Die Klassifikation von Essstörungen steht im Zentrum aktuellen Forschungsinteresses. Gerade relativ rezente diagnostische Kategorien wie die Binge-Eating- oder Essanfallsstörung (Binge Eating Disorder, BED) und diagnostische Hauptmerkmale wie Essanfälle bedürfen im Zuge der Überarbeitungen des DSM einer Überprüfung. In dem vorliegenden Artikel werden zunächst die für das DSM-V vorgeschlagenen Veränderungen der diagnostischen Kriterien der BED und anderer Essstörungen beschrieben. Anschließend wird das Essanfallsmerkmal der Größe der verzehrten Nahrungsmenge in einer Forschungsübersicht hinsichtlich seiner klinischen Relevanz für die BED betrachtet. Dabei zeigt sich, dass sowohl objektive als auch subjektive Essanfälle psychopathologisch relevant sind. Jedoch sind objektive Essanfälle aufgrund ihrer Assoziation mit einem geringeren Behandlungserfolg, einer größeren residualen Symptomatik und vermehrten Rückfalltendenzen das vergleichsweise stringentere Erfolgskriterium in der Therapieerfolgsforschung der BED. Vor diesem Hintergrund erscheint es für die BED zentral, neben objektiven Essanfällen zusätzlich auch subjektive Essanfälle zu erfassen. Für das DSM-V wird empfohlen, ein Schema zu entwerfen, um das Auftreten und die Häufigkeit dieser Formen von Essanfällen für die BED sowie für andere klinische und subklinische Formen von Essanfällen systematisch zu erheben. Eine sorgfältige Erfassung der Essanfallsgröße in Studien zur Psychopathologie, zum Verlauf und zur Behandlung, wird es erlauben, die klinische Relevanz dieses Merkmals über das Essstörungsspektrum hinweg weiter zu klären.

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Effect of Heart Rate Variability on Defensive Reaction and Eating Disorder Symptomatology in Chocolate Cravers

Journal of Psychophysiology ◽

10.1027/0269-8803.23.3.95 ◽

2009 ◽

Vol 23 (3) ◽

pp. 95-103 ◽

Cited By ~ 11

Author(s):

Sonia Rodríguez-Ruiz ◽

Elisabeth Ruiz-Padial ◽

Nieves Vera ◽

Carmen Fernández ◽

Lourdes Anllo-Vento ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Eating Disorder ◽

Eating Behavior ◽

Rest Period ◽

Food Craving ◽

Defensive Reaction ◽

Relevant Role ◽

Eating Disorder Symptomatology ◽

Uncontrolled Eating

The study examines the effect of heart rate variability (HRV) on the cardiac defence response (CDR) and eating disorder symptomatology in chocolate cravers. Female chocolate cravers (n = 36) and noncravers (n = 36) underwent a psychophysiological test to assess their HRV during a 5-min rest period, followed by three trials to explore the CDR, elicited by an intense white noise, during the viewing of chocolate, neutral, and unpleasant pictures. After the test, participants completed a questionnaire to measure eating disorder symptomatology. The HRV was inversely related to the magnitude of the CDR and to eating disorder symptomatology in chocolate cravers. In addition, the HRV was inversely related to the magnitude of the CDR when viewing unpleasant pictures but not to neutral or chocolate ones, across all participants. These findings support the idea that poor autonomic regulation, indexed by low HRV, plays a relevant role in food craving and uncontrolled eating behavior.

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Internal Structure of the Spanish Adaptation of the Eating Disorder Inventory-3

European Journal of Psychological Assessment ◽

10.1027/1015-5759/a000087 ◽

2012 ◽

Vol 28 (1) ◽

pp. 25-31 ◽

Cited By ~ 7

Author(s):

Paula Elosua ◽

Alicia López-Jáuregui

Keyword(s):

Eating Disorders ◽

Eating Disorder ◽

Internal Structure ◽

Internal Consistency ◽

Clinical Sample ◽

Temporal Stability ◽

Second Order ◽

Order Structure ◽

Eating Disorder Inventory ◽

High Internal Consistency

In this study the Eating Disorder Inventory-3 was adapted to Spanish and analyzed the internal psychometric properties of the test in a clinical sample of females with eating disorders. The results showed a high internal consistency of the scores as well as high temporal stability. The factor structure of the scale composites was analyzed using confirmatory factor analysis. The results supported the existence of a second-order structure beyond the psychological composites. The second-order factor showed high correlation with the factor related to eating disorders. Overall, the Spanish version of the EDI-3 showed good psychometric qualities in terms of internal consistency, temporal stability and internal structure.

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