Empirically based subgrouping of eating disorders in adolescents: A longitudinal perspective

1997 ◽  
Vol 170 (4) ◽  
pp. 363-368 ◽  
Author(s):  
Thecla Van Der Ham ◽  
Jacqueline J. Meulman ◽  
Din C. Van Strien ◽  
Herman Van Engeland
Keyword(s):  
Eating Disorders ◽  
Sexual Behaviour ◽  
Body Perception ◽  
Course Of Illness ◽  
Eating Disordered ◽  
Spectrum Hypothesis ◽  
Bulimic Symptoms ◽  
Dsm Iv ◽  
Components Analysis ◽  
Over Time

BackgroundSuccessive DSM versions struggle with the heterogeneity of the eating disorders. Criteria were mainly based on clinical impressions and on descriptive and inferential studies.MethodIn a study of 55 eating-disordered adolescents, we investigated whether patients could be grouped on an empirical basis, using principal components analysis (PCA) with optimal scoring (scaling), i.e. PCA with no a priori assumptions. Clustering was based on Morgan-Russell subscales, each measured four times over the course of illness.ResultsContrary to DSM – IV criteria, patients did not cluster primarily on the basis of anorectic symptoms; the occurrence of bulimic symptoms was more dominant. Core symptomatology (preoccupation with food, disturbed body perception and inadequate sexual behaviour) did not differ between patients, either at referral or over time.ConclusionsThese results support the spectrum hypothesis of the eating disorders, which considers them as one syndrome with different manifestations.

DSM-5 Overview and Goals

2013 ◽  
pp. 1067-1071
Author(s):  
David J. Kupfer ◽  
Susan K. Schultz
Keyword(s):  
Risk Factors ◽  
Clinical Practice ◽  
Mental Disorders ◽  
Organizational Structure ◽  
Psychiatric Research ◽  
Course Of Illness ◽  
The Road ◽  
Dsm 5 ◽  
Dsm Iv ◽  
Over Time

The road to DSM-5 spanned a decade of planning, discussion and review of the considerable advances in psychiatric research and clinical practice. By bridging the strengths of DSM-IV with the opportunities brought by new discoveries in neuroscience, the DSM-5 offers a foundation for future growth as we fill in our gaps of knowledge regarding the underlying pathologies of mental disorders. New features in DSM-5 include an organizational structure that permits alignment of disorders with shared putative pathogenesis irrespective of whether the disorders typically emerge in childhood or later in life. Other features include a new emphasis on risk factors and the development and life course of illness. The goal of the DSM-5 is to create a “living document” that may evolve over time as we gradually build on our knowledge of the neurobiologic underpinnings that account for both the emergence and lifetime expression of mental disorders.

The Classification of Eating Disorders

2010 ◽  
pp. 7-24 ◽  
Author(s):  
Kathryn H. Gordon ◽  
Jill M. Holm-Denoma ◽  
Ross D. Crosby ◽  
Stephen A. Wonderlich
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Latent Class ◽  
Minority Groups ◽  
Statistical Manual ◽  
Text Revision ◽  
Diagnostic And Statistical Manual ◽  
Key Issues ◽  
Dsm Iv

The purpose of the chapter is to elucidate the key issues regarding the classification of eating disorders. To this end, a review of nosological research in the area of eating disorders is presented, with a particular focus on empirically based techniques such as taxometric and latent class analysis. This is followed by a section outlining areas of overlap between the current Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition, Text Revision (DSM-IV-TR; American Psychiatric Association, 2000) eating disorder categories and their symptoms. Next, eating disorder classification models that are alternatives to the DSM-IV-TR are described and critically examined in light of available empirical data. Finally, areas of controversy and considerations for change in next version of the DSM (i.e., the applicability of DSM criteria to minority groups, children, males; the question of whether clinical categories should be differentiated from research categories) are discussed.

scholarly journals Comparison of alternative models for personality disorders

2006 ◽  
Vol 37 (7) ◽  
pp. 983-994 ◽  
Author(s):  
LESLIE C. MOREY ◽  
CHRISTOPHER J. HOPWOOD ◽  
JOHN G. GUNDERSON ◽  
ANDREW E. SKODOL ◽  
M. TRACIE SHEA ◽  
...  
Keyword(s):  
Personality Disorders ◽  
Factor Model ◽  
Five Factor Model ◽  
Collaborative Study ◽  
Validation Data ◽  
Categorical Diagnosis ◽  
Dsm Iv ◽  
Dimensional Models ◽  
Marker Variables ◽  
Over Time

Background. The categorical classification system for personality disorder (PD) has been frequently criticized and several alternative dimensional models have been proposed.Method. Antecedent, concurrent and predictive markers of construct validity were examined for three models of PDs: the Five-Factor Model (FFM), the Schedule for Nonadaptive and Adaptive Personality (SNAP) model and the DSM-IV in the Collaborative Study of Personality Disorders (CLPS) sample.Results. All models showed substantial validity across a variety of marker variables over time. Dimensional models (including dimensionalized DSM-IV) consistently outperformed the conventional categorical diagnosis in predicting external variables, such as subsequent suicidal gestures and hospitalizations. FFM facets failed to improve upon the validity of higher-order factors upon cross-validation. Data demonstrated the importance of both stable trait and dynamic psychopathological influences in predicting external criteria over time.Conclusions. The results support a dimensional representation of PDs that assesses both stable traits and dynamic processes.

A Mediational Model of Autonomy, Self-Esteem, and Eating Disordered Attitudes and Behaviors

1996 ◽  
Vol 20 (2) ◽  
pp. 217-228 ◽  
Author(s):  
Christina M. Frederick ◽  
Virginia M. Grow
Keyword(s):  
Eating Disorders ◽  
College Women ◽  
Self Esteem ◽  
Drive For Thinness ◽  
Cross Sectional ◽  
Eating Disordered ◽  
Mediational Model ◽  
Attitudes And Behaviors ◽  
The Relationship ◽  
Eating Disordered Behaviors

This study expands upon existing literature by examining how the relationship between autonomy deficits and low self-esteem may create a psychological environment conducive to the development of eating disordered behaviors. Findings supported a mediational model to account for eating disordered behaviors in 71 college women. In this model, lack of autonomy was related to decreased global self-esteem, which in turn was associated with bulimia, body dissatisfaction, and drive for thinness. Although only tentative and cross-sectional in nature, this study is of particular importance because it links autonomy and self-esteem in a coherent model predictive of eating disordered behaviors in college women. Developmental aspects of eating disorders and treatment implications are discussed.

Treatment of Antidepressant-Resistant Bulimia with Naltrexone

1987 ◽  
Vol 16 (4) ◽  
pp. 305-309 ◽  
Author(s):  
Jeffrey M. Jonas ◽  
Mark S. Gold
Keyword(s):  
Eating Disorders ◽  
Preliminary Data ◽  
Endogenous Opioids ◽  
Opiate Antagonist ◽  
Percent Reduction ◽  
Bulimic Symptoms ◽  
Long Acting ◽  
Insight Into

Ten individuals with antidepressant-resistant bulimia were treated with the long-acting opiate antagonist naltrexone. Seven of the ten experienced at least a 75 percent reduction of their bulimic symptoms, and have maintained their improvment on three to five month follow-up. These preliminary data suggest that naltrexone may be of use in bulimia unresponsive to standard antidepressant therapy, and may provide insight into the role of endogenous opioids in the etiology of eating disorders.

scholarly journals Violent behaviour in schizophrenia

2005 ◽  
Vol 187 (5) ◽  
pp. 426-430 ◽  
Author(s):  
Jan Vevera ◽  
Alan Hubbard ◽  
Arnošt Veselý ◽  
Hana Papežová
Keyword(s):  
Logistic Regression ◽  
Substance Misuse ◽  
Overt Aggression ◽  
Psychotic Symptoms ◽  
Violent Behaviour ◽  
Stable Conditions ◽  
Dsm Iv ◽  
Available Information ◽  
Overt Aggression Scale ◽  
Over Time

BackgroundA number of studies have reported increased violence in patients with schizophrenia.AimsTo determine the prevalence of violence among those with schizophrenia in samples from 1949, 1969, 1989 and 2000 in Prague (Czech Republic) and to examine trends in this behaviour.MethodRecords from 404 patients meeting DSM–IV criteria for schizophrenia were screened for violence (defined as 3 points on the Modified Overt Aggression Scale) from the first observed psychotic symptoms until the time of latest available information.ResultsLogistic regression revealed a marginally significant increase in violence only inthe 2000 cohort. Overall, violence was associated with schizophrenia in 41.8% of men and 32.7% of women, with no association between substance misuse and violence.ConclusionsThe violence rate found in our sample is expected to remain stable over time under stable conditions. Substance misuse is not the leading cause of violence among those with schizophrenia.

Predictors of outcome in first-episode schizophrenia over the first 4 years of illness

2008 ◽  
Vol 38 (8) ◽  
pp. 1141-1146 ◽  
Author(s):  
P. Whitty ◽  
M. Clarke ◽  
O. McTigue ◽  
S. Browne ◽  
M. Kamali ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
First Episode ◽  
Global Assessment Of Functioning ◽  
Methodological Issues ◽  
Course Of Illness ◽  
Dsm Iv ◽  
First Episode Schizophrenia ◽  
The Relationship ◽  
Positive And Negative Symptoms

BackgroundThe outcome of schizophrenia appears to be more favourable than once thought. However, methodological issues, including the reliance on diagnosis at first presentation have limited the validity of outcome studies to date.MethodWe conducted a first-episode follow-up study of 97 patients with DSM-IV schizophrenia over the first 4 years of illness. First presentation and follow-up assessments were compared using paired t tests and a forced-entry regression analysis was used to determine prognostic variables.ResultsThere were significant improvements in positive and negative symptoms and global assessment of functioning between first presentation and follow-up. At first presentation, fewer negative symptoms (t=−3.40, p<0.01), more years spent in education (t=3.25, p<0.01), and a shorter duration of untreated psychosis (DUP) (t=−2.77, p<0.01) significantly predicted a better outcome at follow-up.ConclusionsThe outcome of schizophrenia may not be as pessimistic as once thought and most patients did not display a downward deteriorating course of illness. This study supports the relationship between DUP and outcome beyond the early stages of illness.

Physical bushfire preparation over time in Victoria, Australia

2017 ◽  
Vol 26 (2) ◽  
pp. 241-251 ◽  
Author(s):  
Carlyn Muir ◽  
John Gilbert ◽  
Rebecca O’Hara ◽  
Lesley Day ◽  
Stuart Newstead
Keyword(s):  
High Risk ◽  
Principal Components ◽  
Content Type ◽  
Significant Difference ◽  
Components Analysis ◽  
Difference Test ◽  
Honest Significant Difference Test ◽  
Preparation Variable ◽  
Physical Preparation ◽  
Over Time

Purpose The purpose of this paper is to examine the level of physical preparation for bushfire among Victorian residents in established high risk bushfire locations, and to assess whether these levels of preparation changed over time. Design/methodology/approach Data were analysed from a telephone survey among Victorian residents (n=614-629) living in high risk bushfire locations over a three-year period (2012-2014). The survey measured residents’ bushfire awareness, knowledge, planning, preparation and engagement with bushfire services. This paper focusses on the extent to which respondents undertook physical preparatory bushfire activities over the three-year period using: first, principal components analysis to generate a single preparation variable by identifying a smaller number of uncorrelated variables (or principal components) from a larger set of data, second, analysis of variance to assess differences in preparation scores between years, and third, Tukey’s honest significant difference test to confirm where the differences occurred between groups. Findings Results indicated only moderate levels of physical preparation for bushfires amongst respondents. The activities that respondents rated the lowest were: “having protective covers for windows” and “having firefighting equipment to protect the house”. A significant difference in total preparation scores over time was observed, F(2, 1,715)=6.159, p<0.005, with lower scores in 2012 compared with 2013 and 2014 scores. Social implications This study found some marginal improvements in levels of physical bushfire preparation from 2012 to 2014. However, the results indicate only moderate levels of preparation overall, despite respondents living in established high risk locations. Originality/value This study provides evidence for the current levels of preparedness in high risk bushfire communities, and emphasises the need for future initiatives to focus on specific bushfire preparation activities but also to consider the broader range of interventions that are likely to contribute to desired safety outcomes.

Is there a Relationship between Sexual Abuse or Incest and Eating Disorders?

1986 ◽  
Vol 31 (7) ◽  
pp. 656-660 ◽  
Author(s):  
G. Sloan ◽  
P. Leichner
Keyword(s):  
Eating Disorders ◽  
Sexual Abuse ◽  
Anorexia Nervosa ◽  
Childhood Sexual Abuse ◽  
Present Article ◽  
Sexual Trauma ◽  
Early History ◽  
Eating Disordered ◽  
Sexual Conflicts ◽  
History Of

The significance of sexual conflicts in many patients with eating disorders has been well documented. However, even when these have been considered to have some degree of etiological importance, the occurrence of actual sexual trauma or incest in the early lives of these patients has been generally neglected in the literature. At one point in time, it was noted that five of six patients on an inpatient unit for eating disorders revealed an early history of sexual abuse or incest. These five cases are described. A parallel is drawn between the psychological problems experienced by victims of childhood sexual abuse and by patients with anorexia nervosa and/or bulimia. Our suspicion that these experiences may not be atypical led to the present article, which has implications for the investigation and management of eating-disordered patients.

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