Anorexia nervosa and attachment

2017 ◽  
Vol 41 (S1) ◽  
pp. S552-S552
Author(s):  
H. De la Red Gallego ◽  
A. Alonso Sánchez ◽  
A. Álvarez Astorga ◽  
S. Gómez Sánchez ◽  
L. Rodríguez Andrés ◽  
...  
Keyword(s):  
Emergency Department ◽  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Clinical Case ◽  
Cognitive Distortions ◽  
Insecure Attachment ◽  
Weight Restoration ◽  
Competing Interest ◽  
The One

IntroductionAttachment is an innate programming whereby a child seeks for security. There is scientific and empirical evidence that insecure attachment is usual in eating disorder patients [1].ObjectivesTo highlight the relevance of attachment between child and caregivers, as well as its significance in therapeutic approach.MethodsA 17-year-old girl hospitalized after attending to emergency department due to fainting. BMI: 12.89. She reports restrictive behavior since age 11 that her mother regards as “child issues”. Divorced parents, she grew up with her mother, diagnosed of hypochondria, who mentions not understanding why she is not the one who is hospitalized.ResultsDuring hospitalization, she turned 18-years-old. Guardianship of her younger siblings was removed to her mother. She had a secure relationship with her 24-year-old sister, so she decided to move in with her. Later on, she had a positive progress, maintaining the gained weight and mood stability, although cognitive distortions persist.ConclusionsAmong developmental and maintaining factors of eating disorders, impaired attachment is becoming increasingly interesting. Even though the main goal of treatment is weight restoration, exploring attachment patterns can facilitate to achieve that aim. This clinical case emphasizes the importance of attachment in eating disorders among child and young adults.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The Unified Protocol for Eating Disorders

2017 ◽  
pp. 150-163
Author(s):  
Christina L. Boisseau ◽  
James F. Boswell
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Emotional Disorders ◽  
Clinical Case ◽  
Case Examples ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Outpatient Settings

This chapter describes the application of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) to eating disorders, including anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder, and other specified feeding or eating disorders. We focus on the five core treatment modules, highlighting aspects of each one that are particularly relevant to eating disorders and discuss the evidence supporting their use. Next, using clinical case examples from both residential and outpatient settings, we illustrate how each of these core modules can be applied to the treatment of eating disorders. Finally, we provide recommendations for future applications of the UP in this population.

Association between eating disorders and 5-HTTLPR polymorphism: The experience of an Italian eating disorders unit

2017 ◽  
Vol 41 (S1) ◽  
pp. S558-S558
Author(s):  
M.G. Oriani ◽  
M. Barchiesi ◽  
L. Sabbatini ◽  
B. Nardi
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Allele Frequency ◽  
Psychiatric Diseases ◽  
Dsm 5 ◽  
Competing Interest ◽  
S Allele ◽  
The Moment

IntroductionEating Disorders (ED) as Anorexia Nervosa (AN), Bulimia Nervosa (BN) and Binge Eating Disorder (BED) are severe and debilitating psychiatric diseases whose etiology is complex and still largely unknown. Several studies seem to suggest that serotonin could be involved and notably there are several associations with 5-HTTLPR polymorphism, especially with the S allele and the S/S genotype.ObjectivesThe purpose of this study is to evaluate if an association between ED and 5-HTTLPR (especially the S allele frequency) can be shown.Material and methodsA group of about 100 subjects attending the eating disorders unit of Ancona will be tested. Their DNA will be taken and the frequency of the S allele will be compared with a control subjects group negative for ED. Then, the ED group will be divided, according to the DSM-5 criteria, in 3 subgroups (AN, BN, BED) and potential differences will be evaluated.ResultsAt the moment, we are still collecting patients. According to other studies involving 5-HTTLPR, the S allele frequency in Italy is comparable with the European one, so there is reason to believe that an association could be found.ConclusionsSerotonin involvement in ED in literature is shown, but it still has to be completely expounded. Studies as this one could help in describing the etiology and the development of this disease.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The disorder of lived corporeality: A possible link between attachment style and eating disorder psychopathology

2017 ◽  
Vol 41 (S1) ◽  
pp. S557-S558 ◽  
Author(s):  
A.M. Monteleone ◽  
G. Castellini ◽  
U. Volpe ◽  
M. Nigro ◽  
F. Zamponi ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Attachment Style ◽  
Attachment Styles ◽  
Phenomenological Theory ◽  
Insecure Attachment ◽  
Self Identity ◽  
Competing Interest ◽  
Early Relationships ◽  
Almost All

IntroductionAccording to the trans-diagnostic perspective, disturbances in eating patterns of eating disorders (EDs) are considered as epiphenomena secondary to the patient's overvaluation of his/her body shape and weight.ObjectivesThe phenomenological theory states that the main feature of ED psychopathology is a disturbance in the way affected persons experience their own body (embodiment). Insecure attachment may promote the development of unstable self-identity leading to use body weight as a source of self-definition.AimsThe aim of our study was to assess the role of embodiment impairments in the relationships between attachment stiles and ED psychopathology.MethodsOne hundred twelve ED patients and 108 healthy subjects filled in the Identity and Eating Disorders (IDEA) questionnaire, which assesses embodiment and personal identity abnormalities, the eating disorder inventory-2 (EDI-2) and the experiences in close relationships (ECR) scale, which defines attachment styles.ResultsED patients showed IDEA, EDI-2 and ECR scores significantly higher than controls. Significant correlations between IDEA scores, insecure attachment and almost all EDI-2 sub-item scores emerged in ED patients but not in controls. IDEA total score mediated the relationship between avoidant attachment and EDI-2 interoceptive awareness.ConclusionsThese findings demonstrate that in ED patients insecure attachment is correlated to disorder of identity and lived corporeality that, in turn, mediates the association between attachment and a specific ED psychopathological trait. Therefore, we suppose that early relationships, through the development of disturbances in identity and embodiment, lead to altered perception of bodily signals and deranged discrimination of one's emotions, which could contribute to EDs.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Management and treatment of feeding and eating disorders

2020 ◽  
pp. 1087-1095
Author(s):  
Susan L. McElroy ◽  
Anna I. Guerdjikova ◽  
Nicole Mori ◽  
Paul L. Houser ◽  
Paul E. Keck
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Behavioural Therapy ◽  
Lisdexamfetamine Dimesylate ◽  
Interpersonal Therapy ◽  
Feeding And Eating Disorders ◽  
Cognitive Behavioural ◽  
Weight Restoration ◽  
Family Based

This chapter reviews the management and treatment of feeding and eating disorders. The cornerstone of managing anorexia nervosa (AN) is refeeding, nutritional rehabilitation, and weight restoration. Evidence of efficacy is strongest for family-based psychotherapy for adolescents with AN. Other forms of psychotherapy have less evidence of efficacy. No medication has regulatory approval for the treatment of AN; agents with possible efficacy are zinc, olanzapine, and dronabinol. For bulimia nervosa, there is evidence of efficacy for cognitive behavioural therapy (CBT), interpersonal therapy (IPT), antidepressants, and topiramate. For binge eating disorder, there is evidence of efficacy for CBT, IPT, lisdexamfetamine dimesylate, topiramate, and antidepressants. Less is known about the management and treatment of pica, rumination disorder, avoidant/restrictive food intake disorder, and other specified feeding or eating disorders. As feeding and eating disorders often co-occur with medical and other psychiatric disorders, the management and treatment of these conditions must also be addressed.

Anorexia nervosa in males

2011 ◽  
Vol 26 (S2) ◽  
pp. 718-718
Author(s):  
R.M. Freire Lucas
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Male Patient ◽  
Clinical Case ◽  
Cultural Factors ◽  
Diagnostic Features ◽  
Diagnostic Difficulties

Eating disorders are far more prevalent in women than men, with only 10% of cases occurring in males. This discrepancy may be partially explained by biological and cultural factors, but it also suggests diagnostic difficulties.Introduced by the description of a clinical case of Anorexia Nervosa (AN) in a male patient, this work reviews and compares diagnostic features of eating disorders, namely AN, in both genders, emphasizing the most common pitfalls to its recognition in men, in order to reduce the number of undiagnosed cases.We searched for scientific articles about this topic on the databases MEDLINE, LILACS and PsycINFO, using the search words “eating disorder”, “anorexia nervosa” and “male”. We chose to preferentially include original articles and recent reviews.

Pharmacotherapy for Eating Disorders

2017 ◽  
Author(s):  
Susan McElroy ◽  
Anna I. Guerdjikova ◽  
Nicole Mori ◽  
Paul E. Keck
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Mental Disorders ◽  
Bulimia Nervosa ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Night Eating Syndrome ◽  
Night Eating

This chapter addresses the pharmacotherapy of the eating disorders (EDs). Many persons with EDs receive pharmacotherapy, but pharmacotherapy research for EDs has lagged behind that for other major mental disorders. This chapter first provides a brief rationale for using medications in the treatment of EDs. It then reviews the data supporting the effectiveness of specific medications or medication classes in treating patients with anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other potentially important EDs, such as night eating syndrome (NES). It concludes by summarizing these data and suggesting future areas for research in the pharmacotherapy of EDs.

Epidemiology and Course of Eating Disorders

2010 ◽  
pp. 24-32 ◽  
Author(s):  
Pamela Keel
Keyword(s):  
Public Health ◽  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
The Public ◽  
Purging Disorder ◽  
Not Otherwise Specified ◽  
Public Health Significance ◽  
Health Significance

The epidemiology of eating disorders holds important clues for understanding factors that may contribute to their etiology. In addition, epidemiological findings speak to the public health significance of these deleterious syndromes. Information on course and outcome are important for clinicians to understand the prognosis associated with different disorders of eating and for treatment planning. This chapter reviews information on the epidemiology and course of anorexia nervosa, bulimia nervosa, and two forms of eating disorder not otherwise specified, binge eating disorder and purging disorder.

Pharmacotherapy of the Eating Disorders

2010 ◽  
pp. 416-451 ◽  
Author(s):  
Susan L. McElroy ◽  
Anna I. Guerdjikova ◽  
Anne M. O’Melia ◽  
Nicole Mori ◽  
Paul E. Keck
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Mental Disorders ◽  
Bulimia Nervosa ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Night Eating Syndrome ◽  
Night Eating

Many persons with eating disorders (EDs) receive pharmacotherapy, but pharmacotherapy research for EDs has lagged behind that for other major mental disorders. In this chapter, we first provide a brief rationale for using medications in the treatment of EDs. We then review the data supporting the effectiveness of specific medications or medication classes in treating patients with anorexia nervosa (AN), bulimia nervosa, binge eating disorder (BED), and other potentially important EDs, such as night eating syndrome (NES) and sleep-related eating disorder (SRED). We conclude by summarizing these data and suggesting future areas for research in the pharmacotherapy of EDs.

scholarly journals Delay Discounting of Reward and Impulsivity in Eating Disorders: From Anorexia Nervosa to Binge Eating Disorder

2017 ◽  
Vol 25 (6) ◽  
pp. 601-606 ◽  
Author(s):  
Trevor Steward ◽  
Gemma Mestre-Bach ◽  
Cristina Vintró-Alcaraz ◽  
Zaida Agüera ◽  
Susana Jiménez-Murcia ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Binge Eating ◽  
Delay Discounting ◽  
Binge Eating Disorder

Anorexia Nervosa and Depression in a Woman Blind since the Age of Nine Months

1993 ◽  
Vol 38 (7) ◽  
pp. 469-471 ◽  
Author(s):  
Clifford W. Sharp
Keyword(s):  
Eating Disorders ◽  
Body Image ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Major Depression ◽  
Food Intake ◽  
Older Women ◽  
The Body ◽  
Atypical Presentation ◽  
History Of

A woman aged 58 who has been blind since the age of nine months presented with major depression and a 40 year history of an eating disorder characterized by a restriction of food intake and body disparagement. The case is additional evidence that a specifically visual body image is not essential for the development of anorexia nervosa and supports the view that the concept of body image is unnecessary and unproductive in eating disorders. Greater emphasis should be placed on attitudes and feelings toward the body, and the possibility of an eating disorder should be considered in cases of older women with an atypical presentation.

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