Controversies and Questions in Current Evaluation, Treatment, and Research Related to Child and Adolescent Eating Disorders

2010 ◽  
pp. 50-72
Author(s):  
James Lock
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Emotional Disorders ◽  
Child And Adolescent ◽  
Outpatient Setting ◽  
Future Research ◽  
Research Issues ◽  
Not Otherwise Specified ◽  
Disorder Symptom ◽  
Adolescent Eating Disorders

This chapter addresses specific diagnostic, treatment, and research issues related to child and adolescent eating disorders. Current diagnostic formulations are inadequate for diagnosing eating disorders such as selective eating, food avoidance emotional disorders, and food phobias in children. Classification schemes for anorexia and bulimia nervosa are not developmentally sensitive, leading to overuse of “eating disorder not otherwise specified” as a diagnosis. Treatment studies in children and adolescents are few; however, those available suggest that certain guidelines are generally applicable. Adolescents with eating disorders should be treated as early as possible in an outpatient setting utilizing parents as resources. Medications, if used, should address comorbid conditions. Data hopefully forthcoming in the next 5 to 10 years will shed light on how best to classify and treat these disorders. Future research should integrate neuropsychological and neurofunctional findings related to brain development, cognitive functioning, and eating disorder symptom development in this age group.

Eating Disorders

2014 ◽  
pp. 391-409
Author(s):  
Robyn Sysko ◽  
G. Terence Wilson
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
American Psychiatric Association ◽  
Behavioral Therapy ◽  
Future Research ◽  
Pharmacological Treatments ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Not Otherwise Specified ◽  
Dsm Iv

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) describes two eating disorder diagnoses, anorexia nervosa (AN) and bulimia nervosa (BN). Provisional criteria are also provided in DSM-IV for binge eating disorder (BED), which is an example of an eating disorder not otherwise specified. This chapter presents a summary and synthesis of research related to the clinical features and treatment of AN, BN, and BED, including studies of prevalence, common comorbidities, and treatment efficacy. Both psychological and pharmacological treatments are reviewed, including cognitive-behavioral therapy, interpersonal psychotherapy, family therapy, and the use of antidepressant medications. Recommendations are made for future research across the eating disorders.

scholarly journals Alexithymia and eating disorders: a critical review of the literature

2021 ◽  
Author(s):  
Matilda E Nowakowski ◽  
Traci McFarlane ◽  
Stephanie Cassin
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Critical Review ◽  
Theoretical Models ◽  
Future Research ◽  
Review Of The Literature ◽  
Eating Disorder Symptoms ◽  
Not Otherwise Specified ◽  
Bodily Sensations

Alexithymia is characterized by difficulties identifying feelings and differentiating between feelings and bodily sensations, difficulties communicating feelings, and a concrete cognitive style focused on the external environment. Individuals with eating disorders have elevated levels of alexithymia, particularly difficulties identifying and describing their feelings. A number of theoretical models have suggested that individuals with eating disorders may find emotions unacceptable and/or frightening and may use their eating disorder symptoms (i.e., restricting food intake, bingeing, and/or purging) as a way to avoid or cope with their feelings. The current critical review synthesizes the literature on alexithymia and eating disorders and examines alexithymia levels across eating disorders (i.e., anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified), the role of alexithymia in binge eating disorder, and the influence of alexithymia on the development of eating disorders as well as treatment outcome. The clinical implications of the research conducted to date and directions for future research are discussed.

Eating Disorders

2010 ◽  
pp. 387-405 ◽  
Author(s):  
Robyn Sysko ◽  
G. Terence Wilson
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
American Psychiatric Association ◽  
Behavioral Therapy ◽  
Future Research ◽  
Pharmacological Treatments ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Not Otherwise Specified ◽  
Dsm Iv

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) describes two eating disorder diagnoses, anorexia nervosa (AN) and bulimia nervosa (BN). Provisional criteria are also provided in DSM-IV for binge eating disorder (BED), which is an example of an eating disorder not otherwise specified. This chapter presents a summary and synthesis of research related to the clinical features and treatment of AN, BN, and BED, including studies of prevalence, common comorbidities, and treatment efficacy. Both psychological and pharmacological treatments are reviewed, including cognitive-behavioral therapy, interpersonal psychotherapy, family therapy, and the use of antidepressant medications. Recommendations are made for future research across the eating disorders.

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.

scholarly journals Longitudinal experiences and impact of the COVID-19 pandemic among people with past or current eating disorders in Sweden

2021 ◽  
Author(s):  
Andreas Birgegård ◽  
Afrouz Abbaspour ◽  
Stina Borg ◽  
David Clinton ◽  
Emma Forsén Mantilla ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Data Availability ◽  
Evidence Based ◽  
List Type ◽  
Convenience Sample ◽  
Eating Disorder Symptom ◽  
Disorder Symptom ◽  
Evidence Based Care ◽  
The Impact

AbstractObjectiveTo document the impact of the COVI-19 pandemic on the health and well-being of individuals with past and current eating disorders in Sweden.MethodWe re-contacted participants from two previous Swedish studies who had a known lifetime history of an eating disorder. Participants completed an online questionnaire about their health and functioning at baseline early in the pandemic (Wave 1; N=982) and six months later (Wave 2); N=646).ResultsThree important patterns emerged: 1) higher current eating disorder symptom levels were associated with greater anxiety, worry, and pandemic-related eating disorder symptom increase; 2) patterns were fairly stable across time, although a concerning number who reported being symptom-free at Wave 1 reported re-emergence of symptoms at Wave 2; and only a minority of participants with current eating disorders were in treatment, and of those who were in treatment, many reported fewer treatment sessions than pre-pandemic and decreased quality of care.ConclusionsThe COVID-19 pandemic is posing serious health challenges for individuals with eating disorders, whether currently symptomatic or in remission. We encourage health service providers and patient advocates to be alert to the needs of individuals with eating disorders and to take active measures to ensure access to appropriate evidence-based care both during and following the pandemic.Significant Outcomes and LimitationsIndividuals with eating disorders symptoms or current active disorder report higher adverse impact of COVID-19 on their mental healthEven individuals who were symptom-free early in the pandemic reported a resurgence of eating disorder symptomsA large proportion of symptomatic individuals were not in treatment for their eating disorder, services should be aware and access to evidence-based care should be ensured across SwedenLimitations included the use of a convenience sample with atypical diagnostic distribution, and a low initial response rate, possibly introducing bias and limiting generalisability.Data Availability StatementFully anonymized data are available from the corresponding author upon request.

Body Dysmorphic Disorder and Eating Disorders

2017 ◽  
pp. 112-125
Author(s):  
Danyale McCurdy-McKinnon ◽  
Jamie D. Feusner
Keyword(s):  
Eating Disorders ◽  
Body Image ◽  
Eating Disorder ◽  
Disordered Eating ◽  
Body Dysmorphic Disorder ◽  
Future Research ◽  
Body Image Concern ◽  
Core Feature ◽  
Visuospatial Processing

This chapter addresses the comorbid presentation of body dysmorphic disorder (BDD) and disordered eating. BDD affects approximately 2% of the population and involves perceived defects of appearance along with obsessive preoccupation and repetitive, compulsive-like behaviors. The prevalence of comorbid BDD and eating disorders is high: Approximately one–third of those with BDD will have a comorbid eating disorder, and almost half of those with an eating disorder will have comorbid BDD. There are complicating diagnostic and treatment factors that arise when an individual experiences both. A core feature of these disorders is body image concern, which may be explained by both shared and unique aberrancies in visual and visuospatial processing that have neurobiological underpinnings. Understanding shared and unique pathophysiology may help inform and guide treatment, as well as open up lines of future research into their etiology.

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.

Cognitive behaviour therapy for eating disorders

2012 ◽  
pp. 1298-1304
Author(s):  
Zafra Cooper ◽  
Rebecca Murphy ◽  
Christopher G. Fairburn
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Cognitive Behaviour Therapy ◽  
Behaviour Therapy ◽  
General Management ◽  
Not Otherwise Specified ◽  
Cognitive Behavioural ◽  
Cognitive Behaviour

The eating disorders provide one of the strongest indications for cognitive behaviour therapy. This bold claim arises from the demonstrated effectiveness of cognitive behaviour therapy in the treatment of bulimia nervosa and the widespread acceptance that cognitive behaviour therapy is the treatment of choice. Cognitive behaviour therapy is also widely used to treat anorexia nervosa although this application has not been adequately evaluated. Recently its use has been extended to ‘eating disorder not otherwise specified’ (eating disorder NOS), a diagnosis that applies to over 50 per cent of cases, and emerging evidence suggests that it is just as effective with these cases as it is with cases of bulimia nervosa. In this chapter the cognitive behavioural approach to the understanding and treatment of eating disorders will be described. The data on the efficacy and effectiveness of the treatment are considered in the chapters on anorexia nervosa and bulimia nervosa (see Chapters 4.10.1 and 4.10.2 respectively), as is their general management.

Feminist-Informed Protective Factors for Subthreshold Eating Disorders

2020 ◽  
Vol 30 (10) ◽  
pp. 1546-1560
Author(s):  
Emily C. Wacker ◽  
Megan L. Dolbin-MacNab
Keyword(s):  
Eating Disorders ◽  
Grounded Theory ◽  
Eating Disorder ◽  
Protective Factors ◽  
Theory Model ◽  
Constructivist Grounded Theory ◽  
Future Research ◽  
Sociocultural Context ◽  
Research And Practice ◽  
Tangible Support

Despite knowledge that the larger sociocultural context contributes to the development of eating disorders, few studies have examined protective factors for women with subthreshold eating disorders. Using feminist-informed constructivist grounded theory methodology, 15 women (ages 18–25 years) with subthreshold eating disorders were interviewed. Results suggest that participants spoke of their subthreshold eating disorders in an externalized way and used protective factors to guide decision making toward their preferred values. A grounded theory model was developed to illustrate this process. Protective factors included (a) people who provide emotional and tangible support, (b) support people who challenge the eating disorder, (c) personal sense of agency, and (d) community activism and involvement. Participants experiencing subthreshold eating disorders demonstrated a capacity to distinguish their own thoughts and values from those of the “eating disorder voice,” and protective factors facilitated this process. Implications for future research and practice are discussed.

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