Implicit family process rules in eating-disordered and non-eating-disordered families.

Family environment has been shown to be one of the factors related to the presence of eating disorders among young-adult females. Clinical experience and theories about eating disorders postulate that implicit family rules are an intricate part of family process that may have a great effect on the creation and maintenance of such problems. This study compared implicit family process rules (specifically rules pertaining to kindness; expressiveness and connection; constraining thoughts, feelings, and self; inappropriate caretaking; and monitoring) in families with a young-adult female diagnosed with an eating disorder-either anorexia nervosa, bulimia nervosa, or eating disorder not otherwise specified-and families with a young-adult female without an eating disorder diagnosis. One hundred two families (51 eating disordered and 51 comparison) participated in the study. Mothers, fathers, young-adult female children, and siblings completed the Family Implicit Rules Profile (Harper, Stoll, & Larson, 2007). Results indicated that eating-disordered families are governed by a greater proportion of constraining family rules than are non-eating-disordered families. Additionally, eating-disordered youth reported a lower proportion of facilitative family rules and a higher proportion of constraining family rules than did parents and siblings. Theoretical, research, and clinical implications are discussed.

The role of spirituality in the treatment of trauma and eating disorders: recommendations for clinical practice.

The relationships among trauma, eating disorders, and spirituality are complex. Both trauma and eating disorders can distance women from their own spirituality, which undermines a potentially important treatment resource. In this article, we offer suggestions based on our clinical experience for helping eating disorder patients who have suffered trauma to rediscover their faith and spirituality. We describe how spirituality can be used as a resource to assist women throughout treatment and in recovery.

Comparative efficacy of spirituality, cognitive, and emotional support groups for treating eating disorder inpatients.

Spiritual interventions are rarely used in contemporary treatment programs and little empirical evidence is available concerning their effectiveness. The purpose of the present study was to evaluate the effectiveness of a spiritual group intervention for eating disorder inpatients. We compared the effectiveness of a Spirituality group with Cognitive and Emotional Support groups using a randomized, control group design. Participants were 122 women receiving inpatient eating disorder treatment. Patients in the Spirituality group tended to score significantly lower on psychological disturbance and eating disorder symptoms at the conclusion of treatment compared to patients in the other groups, and higher on spiritual well-being. On weekly outcome measures, patients in the Spirituality group improved significantly more quickly during the first four weeks of treatment. This study provides preliminary evidence that attending to eating disorder patients' spiritual growth and well-being during inpatient treatment may help reduce depression and anxiety, relationship distress, social role conflict, and eating disorder symptoms.

Intrinsic religiousness and spiritual well-being as predictors of treatment outcome among women with eating disorders.

This study investigated the relationship of religious orientation, religious affiliation, and spiritual well-being with treatment outcomes in an eating disorder inpatient treatment program. Participants were 251 women diagnosed with an eating disorder. Gain scores on the Eating Attitudes Test, Body Shape Questionnaire, Outcome Questionnaire 45.2, and therapist improvement ratings were used as outcome measures. Multiple regression analyses revealed that neither intrinsic religiousness nor religious affiliation were associated with treatment outcomes. Pearson correlations revealed that improvements in spiritual well-being during treatment were significantly associated with positive gains in eating attitudes, less body shape concerns, and positive psychological and social functioning.

Binge and purge processes in bulimia nervosa: a qualitative investigation.

This study explored the nature and functions of the binge and purge processes of those who suffer from bulimia nervosa. Using a qualitative research design, the researchers conducted semi-structured interviews with eight affected women, asking them to discuss their bingeing and purging experiences. Use of an emergent data analysis method revealed participants behaviors as attempts to cope and control, to improve self-regard and social status, to regulate emotion, and to provide physiological reinforcement. Implications of the findings for clinical practice are discussed.