Attachment, body appreciation, and body image quality of life in adolescents with eating disorders.

The aim of the current study was to determine the link between parental attachment style and body appreciation in adolescents with and without eating disorders, and to explore the association between attachment, positive aspects of body image and body image quality of life. The sample comprised 260 adolescents (M age = 15.35, SD age = 1.461): 129 non-clinical participants and 131 adolescents with eating disorders who received treatment in five Eating Disorders Units located in different regions in Spain. They were assessed via the Inventory of Parent and Peer Attachment (IPPA), Body Appreciation Scale (BAS), and Body Image Quality of Life Inventory (BIQLI). There was a significant relation between secure attachment and body appreciation in both groups, and body appreciation was positively related to body image quality of life. Patients with eating disorders had higher body image quality of life when they perceived better communication and trust with their father, which was mediated by the body appreciation they showed. Adolescents without eating disorders showed this same relationship form with their mother. This study aims to highlight the influence of parental attachment on a positive body image in adolescence.

Attachment to parents and friends and body dissatisfaction in adolescents with eating disorders.

The study of attachment is a valuable theoretical framework to understand the influence of parents and friends on the evolution and development of adolescents. This study aimed to determine parents' and peers' attachment style, the relationship between parents' and peers' attachment and body dissatisfaction in adolescents with eating disorders (ED), and to compare it with a control group. The sample consisted of 260 adolescents (Mage = 15.35, SDage = 1.461): a control group consisting of 129 non-clinical subjects and an ED group composed by 131 adolescents diagnosed with ED who attended five ED units located in different regions of Spain. They completed the Body Shape Questionnaire (BSQ-34) and the Inventory of Parent and Peer Attachment (IPPA). Adolescents with ED have less trust with their parents, worse communication with their parents and peers, and greater alienation with fathers and peers. The results showed a statistically significant relationship between parents' attachment and body dissatisfaction in both groups. In ED group, peers' alienation was positively correlated to body dissatisfaction. Parental attachment and alienation feelings with peers could influence body dissatisfaction in ED adolescents.

Trastorno mental grave, sin hogar y creencias religiosas inusuales: a propósito de un caso / Serious mental illness, homeless and unusual religious beliefs: presentation of a case

OBJETIVO: El interés del caso es la documentación de las vicisitudes asistenciales de personas con TMG que se presentan con creencias religiosas inusuales (nuestra paciente era devota de Hare Krishna) y que además estén en una insólita situación de desaparición y necesidad de identificación policial. CASO CLÍNICO: Se trata de una mujer con diagnóstico de trastorno psicótico crónico, que fue ingresada en una Unidad de Hospitalización de Adultos de Psiquiatría por orden judicial. Transcurridas varias semanas de su ingreso, finalmente, fue identificada por la policía científica, donde constaba que se encontraba desaparecida desde hacía dos años en otra Comunidad Autónoma. RESULTADOS: Entre las personas sin hogar destaca una elevada prevalencia de trastorno mental, patología dual o ambos. En recientes estudios se encontraron las siguientes características sociodemográficas: mayor proporción de hombres, edad media, más sintomatología médica, bajo nivel de educación, mayor gravedad de síntomas psiquiátricos, con un deterioro funcional grave, periodos de más de 36 meses de estar sin hogar, y casi la mitad presentaban abuso de sustancias. Se encontró que el 78% de los pacientes tenían trastorno mental con psicosis. Además, en otro estudio, se objetivó que la mortalidad en mujeres indigentes de más de 45 años era más del doble de lo esperado. CONCLUSIONES: Sería conveniente mejorar las estructuras y procesos del trabajo comunitario, como se realiza en otros países de Europa, para poder atender a las personas sin hogar de una forma más adecuada, asegurando que reciben los servicios de salud que requieran

OBJECTIVE: The interest of this case is the documentation of the healthcare vicissitudes of people with Severe Mental Illness (SMI) who have unusual religious beliefs (our patient was a devotee of Hare Krishna), and who are also in an unusual situation of disappearance, and need of police identification. CLINICAL CASE: This is a woman diagnosed with chronic psychotic disorder, who was admitted to an Adult Psychiatric Ward by court order. After several weeks of admission, she was finally identified by the forensic police, stating that she had been missing for two years in another city. RESULTS: There is a high prevalence of mental disorder and/or dual disorder among the homeless. In recent studies the following sociodemographic characteristics were found: higher proportion of men, middle aged, more medical symptoms, low level of education, greater severity of psychiatric symptoms, with severe functional impairment, periods of more than 36 months of being homeless, and almost half had substance abuse. More than three-quarters (78%) of patients were found to have mental disorder with psychosis. Furthermore, in another study, it was found that mortality was more than double that expected in homeless women over 45 years old. CONCLUSIONS: It would be worthwhile to improve the structures and processes of community work, as has happened in other European countries, in order to be able to attend to the homeless in a more adequate way, ensuring that they receive the health services they deserve

Do parents perceive the abnormal eating attitudes of their adolescent children with anorexia nervosa?

Parents are often the first to detect the initial signs of anorexia nervosa (AN) and take necessary measures to ensure that their children receive appropriate treatment. The evaluation of AN in adolescence is complicated by taking into account the tendency to minimize and deny the symptoms by adolescents, and the difficulty of parents in detecting the main symptoms. We compared the adolescent and parent scores on measures of disordered eating at initial presentation. The sample consisted of 62 adolescents diagnosed with AN, who attended an eating disorder children's unit. Adolescents completed the Eating Attitudes Test (EAT-40) and their parents the Anorectic Behavior Observation Scale (ABOS). The questionnaire data were collected as part of the routine clinical practice and were obtained from clinical notes. The findings indicate no significant correlations between the EAT-40 and ABOS scores, or between AN subtypes according to parent observation of symptoms. There were significant differences between parents, with mothers reporting higher scores than fathers. This study highlights the importance of psychoeducation for parents on the early signs of AN, in order to improve recognition and diagnosis at initial assessment of their adolescent children in the early phases.

The influence of the aesthetic body shape model on adolescents with eating disorders.

INTRODUCTION: the relevance of sociocultural factors with respect to etiology, development and treatment of eating disorders has been supported by many studies. OBJECTIVES: the aims of this study were: a) to analyze the different effects of the aesthetic body shape model on adolescents with anorexia nervosa (AN) vs bulimia nervosa (BN); b) to analyze possible differences, regarding that body shape model, between patients with purging behaviors vs non purging types of patients; and c) to explore the relationship between the influence of the aesthetic body shape model and other clinically relevant variables such as body dissatisfaction, eating attitudes and personality traits. METHODS: the sample comprised 104 adolescents suffering from AN and BN. The Questionnaire of Influences on the Aesthetic Body Shape Model (CIMEC-40), the Body Shape Questionnaire (BSQ), the Eating Attitudes Test (EAT-40) and the Millon Adolescent Clinical Inventory (MACI) were applied. RESULTS: the aesthetic body shape model of thinness influenced 77.9% of this sample, this influence being higher in the case of BN patients. In addition, that influence was stronger in the purging-type patients than in the non-purging type. Moreover, there was a significant and positive correlation among the influence of the aesthetic body shape model, body dissatisfaction and severity of eating symptoms. Finally, there seems to exist some personality traits more vulnerable to be affected by sociocultural factors. CONCLUSIONS: in view of these results, it is necessary that psychotherapeutic approaches take into account the influence of sociocultural factors and body dissatisfaction mainly in the case of adolescents with BN.

The influence of the aesthetic body shape model on adolescents with eating disorders / La influencia del modelo estético corporal en los trastornos de conducta alimentaria en la adolescencia

Introduction: the relevance of sociocultural factors with respect to etiology, development and treatment of eating disorders has been supported by many studies. Objectives: the aims of this study were: a) to analyze the different effects of the aesthetic body shape model on adolescents with anorexia nervosa (AN) vs bulimia nervosa (BN); b) to analyze possible differences, regarding that body shape model, between patients with purging behaviors vs non purging types of patients; and c) to explore the relationship between the influence of the aesthetic body shape model and other clinically relevant variables such as body dissatisfaction, eating attitudes and personality traits. Methods: the sample comprised 104 adolescents suffering from AN and BN. The Questionnaire of Influences on the Aesthetic Body Shape Model (CIMEC-40), the Body Shape Questionnaire (BSQ), the Eating Attitudes Test (EAT-40) and the Millon Adolescent Clinical Inventory (MACI) were applied. Results: the aesthetic body shape model of thinness influenced 77.9% of this sample, this influence being higher in the case of BN patients. In addition, that influence was stronger in the purging-type patients than in the non-purging type. Moreover, there was a significant and positive correlation among the influence of the aesthetic body shape model, body dissatisfaction and severity of eating symptoms. Finally, there seems to exist some personality traits more vulnerable to be affected by sociocultural factors. Conclusions: in view of these results, it is necessary that psychotherapeutic approaches take into account the influence of sociocultural factors and body dissatisfaction mainly in the case of adolescents with BN

Introducción: la relevancia de los factores socioculturales en la etiología, el desarrollo y el tratamiento de los trastornos de la conducta alimentaria ha sido apoyada por varios estudios. Objetivos: los objetivos del presente estudio fueron evaluar las diferencias en la influencia del modelo estético corporal en adolescentes diagnosticadas de anorexia nerviosa (AN) y bulimia nerviosa (BN), y explorar la relación existente entre la influencia del modelo estético corporal y otras variables clínicamente relevantes, como la insatisfacción corporal, la presencia de conductas purgativas, las actitudes hacia la comida y los rasgos de personalidad. Método: la muestra se compuso de 104 adolescentes con diagnostico de AN y BN. Los instrumentos de evaluación utilizados fueron el Cuestionario de Influencias sobre el Modelo Estético Corporal (CIMEC-40), el Body Shape Questionnaire (BSQ), el Test de Actitudes Alimentarias (EAT-40) y el Inventario Clínico para Adolescentes de Millón (MACI). Resultados: los resultados obtenidos indican que la mayoría de la muestra esta influenciada por el modelo estético corporal de delgadez. En cambio, las pacientes con BN están significativamente mas influenciadas por el modelo estético que las pacientes con AN, provocando en las pacientes con BN una mayor insatisfacción corporal y propiciando la aparición de síntomas bulímicos, sobre todo de tipo purgativo. Por otro lado, parecen existir rasgos de personalidad mas susceptibles a la influencia de los factores socioculturales, que pueden mediar entre la influencia del modelo estético, la insatisfacción y la aparición de síntomas. Conclusiones: a la vista de los resultados, se requiere que las medidas de intervención psicoterapéuticas se adapten a la mayor influencia de los factores socioculturales y de insatisfacción corporal en la BN durante la adolescencia

Body dissatisfaction in adolescents with eating disorders.

PURPOSE: This study aims to analyze and compare the level of body dissatisfaction (BD) in different eating disorders (ED) subtypes. Also, the relationship between BD and certain aesthetic body shape model influence and psychological variables was analyzed. METHODS: The sample consisted of 204 adolescent patients, who were attending in an ED Unit in Zaragoza (Spain). The following instruments were applied: the Spanish Children's Depression Questionnaire (CEDI-II), the Rosenberg Self-Esteem Scale (RSES), the Eating Attitudes Test (EAT-40), the Body Shape Questionnaire (BSQ-34) and the Questionnaire of Influences of Aesthetic Body shape Model (CIMEC-40). RESULTS: The group of Bulimia Nervosa (BN) showed the greatest BD. Those patients who showed higher levels of BD had lower self-esteem, more depressive symptoms, a greater presence of disordered eating attitudes, and more influence of the aesthetic body shape model. CONCLUSIONS: This study contributes to highlight the idea of implementing effective prevention programs and specific interventions related to BD in the treatment of ED.

Eating disorders during the adolescence: personality characteristics associated with anorexia and bulimia nervosa.

INTRODUCTION: Previous studies provide relevant information about the relationship between personality and eating disorders (ED). The involvement of personality factors in the etiology and maintenance of ED indicates the need of emphasizing the study of the adolescent's personality when diagnosed of ED. OBJECTIVES: The aims of this study were to analyze the adolescent's personality profiles that differ significantly in anorexia nervosa (AN) and bulimia nervosa (BN), and to explore the most common profiles and their associations with those subtypes of eating disorders (ED). METHODS: A total of 104 patients with AN and BN were studied by means of the Millon Adolescent Clinical Inventory (MACI). RESULTS: The personality profiles that differ significantly in both AN and BN were submissive, egotistic, unruly, forceful, conforming, oppositional, self-demeaning and borderline. The most frequent profiles in AN were conforming (33.33%), egotistic (22.72%) and dramatizing (18.18%) while in the case of BN those profiles were unruly (18.42%), submissive (18.42%) and borderline (15.78%). We did not find any associations between the diagnostic subgroup (AN, BN) and the fact of having personality profiles that could become dysfunctional. CONCLUSIONS: Bearing in mind these results, it may be concluded that there are relevant differences between personality profiles associated with AN and BN during adolescence, so tailoring therapeutic interventions for this specific population would be important.

Eating disorders during the adolescence: personality characteristics associated with anorexia and bulimia nervosa / Trastornos de la conducta alimentaria durante la adolescencia: perfiles de personalidad asociados a la anorexia y a la bulimia nerviosa

Introduction: Previous studies provide relevant information about the relationship between personality and eating disorders (ED). The involvement of personality factors in the etiology and maintenance of ED indicates the need of emphasizing the study of the adolescent's personality when diagnosed of ED. Objectives: The aims of this study were to analyze the adolescent's personality profiles that differ significantly in anorexia nervosa (AN) and bulimia nervosa (BN), and to explore the most common profiles and their associations with those subtypes of eating disorders (ED). Methods: A total of 104 patients with AN and BN were studied by means of the Millon Adolescent Clinical Inventory (MACI). Results: The personality profiles that differ significantly in both AN and BN were submissive, egotistic, unruly, forceful, conforming, oppositional, self-demeaning and borderline. The most frequent profiles in AN were conforming (33.33%), egotistic (22.72%) and dramatizing (18.18%) while in the case of BN those profiles were unruly (18.42%), submissive (18.42%) and borderline (15.78%). We did not find any associations between the diagnostic subgroup (AN, BN) and the fact of having personality profiles that could become dysfunctional. Conclusions: Bearing in mind these results, it may be concluded that there are relevant differences between personality profiles associated with AN and BN during adolescence, so tailoring therapeutic interventions for this specific population would be important (AU)

Introducción: estudios previos aportan información relevante sobre la relación entre la personalidad y los trastornos de conducta alimentaria (TCA). La implicación de los factores de personalidad en la etiología y el mantenimiento de los TCA indica la necesidad de enfatizar el estudio de la personalidad del adolescente cuando se diagnostique un TCA. Objetivos: los objetivos del presente estudio fueron explorar los perfiles de personalidad más frecuentes asociados a la anorexia nerviosa (AN) y a la bulimia nerviosa (BN) en adolescentes y analizar aquellos perfiles de personalidad que diferencian de manera significativa a ambos subtipos de TCA. Métodos: un total de 104 pacientes con diagnóstico de AN y BN fueron estudiados mediante el Inventario Clínico para Adolescentes de Millon (MACI). Resultados: los perfiles de personalidad que difieren significativamente entre AN y BN fueron los perfiles sumiso, egocéntrico, rebelde, rudo, conformista, oposicionista, autopunitivo y tendencia límite. Los perfiles de personalidad más frecuentes en la AN fueron el conformista (33,33%), el egocéntrico (22,72%) y el histriónico (18,18%), mientras que en la BN los más prevalentes fueron el rebelde (18,42%), el sumiso (18,42%) y el límite (15,78%). No encontramos ninguna asociación entre el subgrupo diagnóstico (AN, BN) y el hecho de tener perfiles de personalidad que podrían llegar a ser disfuncionales. Conclusiones: existen diferencias relevantes entre los perfiles de personalidad asociados a la AN y la BN durante la adolescencia, por lo que sería importante adaptar las intervenciones terapéuticas para esta población específica (AU)