Differences in caloric utilization in eating disordered adolescents.

Caloric utilization is an important aspect of the clinical management of eating disorders. Caloric intake and body weight of 32 inpatient bulimic and anorectic girls and 30 normal adolescents were measured. Normal weight bulimics ate fewer calories while anorectics ate more calories per kilogram body weight compared with the control group. Anorectics have greater difficulty to eat sufficient calories to maintain their weight. These findings indicate that treatment should be extended beyond the point of time where normal weight is reached.

A comparison of adolescent and adult defense styles.

Despite the great need for assessment of the adaptive and defensive style of adolescents, there are few instruments available to assess these characteristics. We assessed Vaillant's defense hierarchial model in adolescents, using Bond's self-report questionnaire (DSQ) for adults adopted for adolescents. In all cases, the factor structure in adolescents differed from adults, which may represent a manifestation of development.

Psychological characteristics and DSM-III-R diagnoses at 6-year follow-up of adolescent anorexia nervosa.

OBJECTIVE: To examine the relationship between psychiatric disorder and psychological characteristics at 6-year follow-up of adolescent-onset anorexia nervosa. METHOD: Twenty-three subjects were interviewed by telephone using the Structured Clinical Interview for DSM-III-R diagnosis. These subjects and 23 demographically similar controls completed standardized questionnaires that assessed their defense and coping styles, level of depression, defensiveness, and eating disorder psychopathology. RESULTS: Of the anorexic subjects 35% had no DSM-III-R diagnosis, 43% an eating disorder, (9% anorexia nervosa, 17% bulimia nervosa, 22% eating disorder not otherwise specified), 30% an affective disorder, and 43% an anxiety disorder at follow-up. Factors at presentation associated with good outcome included greater use of mature defenses, less depression, and a lower drive for thinness. Psychological characteristics of anorexic subjects with good outcome resembled those of controls except that the former anorexics expressed greater dissatisfaction with their bodies and reported less use of cognitive avoidance as a coping mechanism. Anorexic subjects with continuing psychiatric problems differed from controls on most of the measures studied. CONCLUSIONS: Distribution of psychiatric disorders at follow-up is similar for adolescent and adult-onset anorexia nervosa. Self-report measures of some psychological characteristics are useful prognostic indicators. Absence of psychiatric disorder at follow-up is associated with normalization of many psychological characteristics.