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1.
Int J Clin Pract ; 73(11): e13401, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31397950

RESUMO

OBJECTIVE: While physical activity (PA) is known to have positive effects on psychological and physical health, little is understood about the association between non-compensatory PA (ie, not compulsive or intended to control weight or shape) and psychopathology among individuals with eating-disorder features. The present study explored associations between non-compensatory PA and psychopathology among adults categorised with bulimia nervosa (BN) and binge-eating disorder (BED). We further explored the association between compensatory PA and psychopathology among those who engaged in that form of "purging." METHOD: Participants were recruited through Mechanical Turk, an online recruitment platform. Individuals categorised with core features of BED (N = 138) and BN (N = 138) completed measures of eating-disorder psychopathology (Eating Disorder Examination - Questionnaire [EDE-Q] and Questionnaire on Eating and Weight Patterns - 5), depression (Patient Health Questionnaire - 2) and PA (both non-compensatory and compensatory, measured using the EDE-Q and Godin Leisure-Time Exercise Questionnaire). RESULTS: Engagement in non-compensatory PA was associated with lower frequency of binge-eating episodes, lower overvaluation of shape/weight and lower dissatisfaction with shape/weight (Ps < .05). Engagement in compensatory PA was related to greater frequency of binge-eating episodes and greater restraint (Ps < .05). DISCUSSION: Non-compensatory PA was associated with lower eating-disorder psychopathology. This suggests that PA is an important, though understudied, health behaviour among persons with features of BED and BN. Future research should examine the potential role of non-compensatory PA in interventions for individuals with core features of these eating disorders.


Assuntos
Transtorno da Compulsão Alimentar/psicologia , Bulimia Nervosa/psicologia , Exercício Físico/psicologia , Comportamento Alimentar/psicologia , Adulto , Transtorno da Compulsão Alimentar/fisiopatologia , Peso Corporal , Bulimia/diagnóstico , Bulimia Nervosa/fisiopatologia , Depressão/psicologia , Feminino , Humanos , Masculino , Inquéritos e Questionários
3.
Eat Weight Disord ; 24(1): 37-45, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30414076

RESUMO

PURPOSE: To assess the dimensionality and psychometric properties of the modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) in an Italian non-clinical sample. METHODS: 262 adults (184 women) were administered the Italian versions of the mYFAS 2.0, and questionnaires measuring binge eating severity, anxiety and depression symptoms, and emotional dysregulation. RESULTS: 15 individuals (5.7%) met the criteria for a diagnosis of food addiction according to the mYFAS 2.0. Bayesian confirmatory factor analysis supported a single-factor solution for the mYFAS 2.0. The mYFAS 2.0 had good internal consistency (Ordinal α = 0.91), and convergent validity with binge eating severity (r = 0.67, p < 0.001), both anxiety (r = 0.31, p < 0.001) and depressive (r = 0.35, p < 0.001) symptoms, and difficulties in emotion regulation (r = 0.35, p < 0.001). Finally, both discriminant validity with dietary restraint (Gamma = 0.11; p = 0.52) and incremental validity in predicting binge eating severity over emotion dysregulation and psychopathology (b = 0.52; t = 11.11; p < 0.001) were confirmed. CONCLUSIONS: The Italian mYFAS 2.0 has satisfactory psychometric properties and can be used as a brief instrument for the assessment of addictive eating behaviors when time constraints prevent the use of the original version. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.


Assuntos
Bulimia/diagnóstico , Emoções/fisiologia , Dependência de Alimentos/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Bulimia/psicologia , Estudos Transversais , Ingestão de Alimentos/psicologia , Comportamento Alimentar/psicologia , Feminino , Dependência de Alimentos/psicologia , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Adulto Jovem
4.
Eat Behav ; 31: 131-136, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30359908

RESUMO

Although relationships between negative affect, emotion dysregulation, and binge eating have been well-established, the mechanisms and individual risk factors that account for this relationship have yet to be elucidated. In addition to emotion dysregulation, altered reward functioning and negative affect eating expectancies (i.e., the expectancy that eating will relieve negative affect) are factors that have been previously linked to binge eating, though theoretical frameworks have not provided an integrated conceptualization of relationships between these domains. Therefore, the present study examined an integrative moderated mediation model among a sample of 101 adults with self-reported eating disorder (ED) symptoms who completed a battery of online questionnaires. Results supported the hypothesized model, which demonstrated that eating expectancies mediated the relationship between emotion dysregulation and binge eating frequency, and there was a positive association between emotion dysregulation and eating expectancies among individuals high in anticipatory reward. These findings provide preliminary support for an integrated approach to understanding transdiagnostic and ED-specific risk factors that potentiate binge eating.


Assuntos
Bulimia/diagnóstico , Bulimia/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Adolescente , Adulto , Emoções/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Psicológicos , Recompensa , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
5.
Nutrients ; 10(9)2018 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-30223500

RESUMO

Binge eating is a core diagnostic feature of bulimia nervosa, binge eating disorder, anorexia nervosa binge/purge type, and is a common feature of "other specified" and "unspecified" feeding and eating disorders. It has been suggested that specific metacognitive beliefs about food, eating, and binge eating may play a key role in the maintenance of binge eating behaviour. The Eating Beliefs Questionnaire (EBQ-18) provides a brief self-report assessment tool measuring three types of metacognitive beliefs: negative, positive, and permissive beliefs about food and eating. This study aimed to build on past research by validating the factor structure and psychometric properties of the EBQ-18 using both a clinical and non-clinical sample. A sample of 688 participants (n = 498 non-clinical participants, n = 161 participants seeking treatment for an eating disorder, and n = 29 participants seeking treatment for obesity) completed a battery of questionnaires, including the EBQ-18 and other measures of eating disorder symptoms and relevant constructs. A subset of 100 non-clinical participants completed the test battery again after an interval of two-weeks, and 38 clinical participants completed the EBQ-18 before and after receiving psychological treatment for their eating disorder. A confirmatory factor analysis (CFA) was conducted and psychometric properties of this measure were assessed. The results of this study provide support for the three-factor model of the EBQ-18. In addition, the EBQ-18 was found to be a valid and reliable measure, with excellent internal consistency, good test-retest reliability in the non-clinical sample, and also demonstrated evidence of sensitivity to treatment in clinical samples with binge eating pathology. Receiver operating characteristic (ROC) curve analyses were used to identify optimal cut-off scores for the EBQ-18. This study provides valuable information about the utility of the EBQ-18 as a measure for use in both clinical and research settings.


Assuntos
Transtorno da Compulsão Alimentar/psicologia , Bulimia/psicologia , Comportamento Alimentar/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Obesidade/psicologia , Psicometria , Autorrelato , Adolescente , Adulto , Transtorno da Compulsão Alimentar/diagnóstico , Transtorno da Compulsão Alimentar/terapia , Bulimia/diagnóstico , Bulimia/terapia , Cultura , Feminino , Humanos , Masculino , Metacognição , Obesidade/diagnóstico , Obesidade/terapia , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Adulto Jovem
6.
Psychiatry Res ; 267: 108-111, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29886272

RESUMO

The study examined associations between eating disorder behaviors measured via ecological momentary assessment (EMA) and eating disorder quality of life (EDQOL) in anorexia nervosa (AN). Women with AN (N = 82) completed an EDQOL measure and two-weeks of EMA. Greater frequency of EMA-assessed restriction and bulimic behavior were independently related to lower EDQOL scores. Lower psychological EDQOL was associated with increased EMA dietary restriction; lower work-related EDQOL was associated with increased EMA binge eating; aspects of EDQOL were unrelated to EMA purging. Findings suggest that severity of restriction and bulimic behaviors may serve as severity indicators of EDQOL in AN.


Assuntos
Anorexia Nervosa/diagnóstico , Anorexia Nervosa/psicologia , Qualidade de Vida/psicologia , Inquéritos e Questionários , Adulto , Anorexia Nervosa/epidemiologia , Transtorno da Compulsão Alimentar/diagnóstico , Transtorno da Compulsão Alimentar/epidemiologia , Transtorno da Compulsão Alimentar/psicologia , Bulimia/diagnóstico , Bulimia/epidemiologia , Bulimia/psicologia , Comportamento Alimentar/psicologia , Feminino , Humanos , Pessoa de Meia-Idade
7.
Nutrients ; 10(1)2018 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-29320461

RESUMO

Although there are numerous studies on binge eating behavior in the Western countries, studies on this behavior in Malaysia are still limited. Therefore, this cross-sectional study aimed to determine the risk factors associated with binge eating behavior among adolescents in Malaysia. The study included 356 adolescents (42.7% males and 57.3% females), aged 13 to 16 years. They completed a self-administered questionnaire on demographic and socioeconomic backgrounds, frequency of family meals, family meal environments, family cohesion, perception of body size, self-esteem, depressive symptoms, perfectionistic self-presentation, and binge eating behavior. Furthermore, their weight, height, and waist circumference were measured. It was found that 14.0% of the participants engaged in binge eating behavior (15.2% in females and 12.5% in males). Additionally, it was identified that high levels of depressive symptoms, high levels of body dissatisfaction, poor family cohesion, and low self-esteem were significantly contributed to binge eating behavior after controlling for sex (adjusted R² = 0.165, F = 15.056, p < 0.001). The findings may suggest that improving the relationships between family members, along with eliminating adolescents' negative emotions could help in the prevention of binge eating behavior among adolescents. The identified modifiable risk factors should be incorporated into binge eating preventive programs to increase the effectiveness of the programs.


Assuntos
Comportamento do Adolescente , Grupo com Ancestrais do Continente Asiático/psicologia , Bulimia/psicologia , Comportamento Alimentar , Adolescente , Comportamento do Adolescente/etnologia , Fatores Etários , Imagem Corporal , Bulimia/diagnóstico , Bulimia/etnologia , Estudos Transversais , Depressão/diagnóstico , Depressão/etnologia , Depressão/psicologia , Relações Familiares/etnologia , Comportamento Alimentar/etnologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Humanos , Malásia/epidemiologia , Masculino , Fatores de Risco , Senso de Coerência , Fatores Socioeconômicos , Inquéritos e Questionários
8.
J Psychiatr Res ; 96: 183-188, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29078155

RESUMO

OBJECTIVE: The objective of this study was to investigate predictors of long-term recovery from eating disorders 22 years after entry into a longitudinal study. METHOD: One hundred and seventy-six of the 228 surviving participants (77.2%) were re-interviewed 20-25 years after study entry using the Longitudinal Interval Follow-up Evaluation to assess ED recovery. The sample consisted of 100 women diagnosed with anorexia nervosa (AN) and 76 with bulimia nervosa (BN) at study entry. RESULTS: A comorbid diagnosis of major depression at the start of the study strongly predicted having a diagnosis of AN-Restricting type at the 22-year assessment. A higher body mass index (BMI) at study intake decreased the odds of being diagnosed with AN-Binge Purge type, relative to being recovered, 22 years later. The only predictor that increased the likelihood of having a diagnosis of BN at the 22-year assessment was the length of time during the study when the diagnostic criteria for BN were met. CONCLUSIONS: Together, these results indicate that the presence and persistence of binge eating and purging behaviors were poor prognostic indicators and that comorbidity with depression is particularly pernicious in AN. Treatment providers might pay particular attention to these issues in an effort to positively influence recovery over the long-term.


Assuntos
Anorexia Nervosa/diagnóstico , Bulimia Nervosa/diagnóstico , Adolescente , Adulto , Anorexia Nervosa/complicações , Anorexia Nervosa/epidemiologia , Bulimia/complicações , Bulimia/diagnóstico , Bulimia/epidemiologia , Bulimia Nervosa/complicações , Bulimia Nervosa/epidemiologia , Comorbidade , Transtorno Depressivo Maior/complicações , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/epidemiologia , Feminino , Seguimentos , Humanos , Modelos Logísticos , Estudos Longitudinais , Pessoa de Meia-Idade , Prognóstico , Recuperação de Função Fisiológica , Fatores de Tempo , Adulto Jovem
10.
J Clin Child Adolesc Psychol ; 47(5): 770-784, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-27399285

RESUMO

There is evidence that intrapersonal psychological factors might contribute to the development of binge eating. However, studies considering reciprocal effects between risk factors and disordered eating are rare. The present article investigates the nature of the temporal relationships between binge eating and low self-esteem, depressive symptoms, interoceptive deficits, perfectionism, weight/shape concerns, dietary restraint, and the internalization of the societal body ideal in adolescence while taking into account the moderating effects of age and gender. A German population-based sample of 1039 boys and girls from 12 to 19 years of age answered self-report questionnaires on risk factors and eating pathology on 2 measurement points separated by 20 months. Data were analyzed using a cross-lagged panel design. Low self-esteem, interoceptive deficits, weight/shape concerns, and the internalization of the societal body ideal predicted binge eating longitudinally in bivariate analyses. Binge eating predicted later depressive symptoms, whereas perfectionism and dietary restraint were not longitudinally linked to binge eating in either direction. Low self-esteem and weight/shape concerns emerged as multivariate predictors of binge eating in girls and boys, respectively. No moderating effects of age were observed. The results suggest that depressive symptoms might rather be a consequence of binge eating than a risk factor, and this underscores that even subclinical eating pathology might be associated with negative psychological outcomes. Central risk factors that should be targeted in prevention programs might be low self-esteem for girls and weight/shape concerns for boys.


Assuntos
Comportamento do Adolescente/psicologia , Transtorno da Compulsão Alimentar/psicologia , Bulimia/psicologia , Adolescente , Comportamento do Adolescente/fisiologia , Transtorno da Compulsão Alimentar/diagnóstico , Transtorno da Compulsão Alimentar/epidemiologia , Peso Corporal/fisiologia , Bulimia/diagnóstico , Bulimia/epidemiologia , Criança , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/psicologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Estudos Prospectivos , Psicologia , Fatores de Risco , Autorrelato , Inquéritos e Questionários , Adulto Jovem
11.
Trials ; 18(1): 592, 2017 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-29233169

RESUMO

BACKGROUND: Cognitive behavior therapy (CBT) is the first-line of treatment for overweight and obesity patients whose problems originate in maladaptive eating habits (e.g., emotional eating). However, in-person CBT is currently difficult to access by large segments of the population. The proposed SIGMA intervention (i.e., the Self-help, Integrated, and Gamified Mobile-phone Application) is a mHealth intervention based on CBT principles. It specifically targets overweight young adults with underlying maladaptive behaviors and cognitions regarding food. The SIGMA app was designed as a serious game and intended to work as a standalone app for weight maintenance or alongside a calorie-restrictive diet for weight loss. It uses a complex and novel scoring system that allows points earned within the game to be supplemented by points earned during outdoor activities with the help of an embedded pedometer. METHODS/DESIGN: The efficacy of the SIGMA mHealth intervention will be investigated within a randomized, placebo-controlled trial. The intervention will be set to last 2 months with a 3-month follow-up. Selected participants will be young overweight adults with non-clinical maladaptive eating habits embodied by food cravings, binge eating, and emotional eating. The primary outcomes will be represented by changes in (1) self-reported maladaptive thoughts related to eating and body weight, (2) self-reported maladaptive eating behaviors in the range of urgent food cravings, emotional eating or binge eating, (3) as well as biased attentional processing of food items as indexed by reaction times. Secondary outcomes will be represented by changes in weight, Body Mass Index, general mood, and physical activity as indexed by the number of steps per day. DISCUSSION: Through an evidence-based cognitive behavioral approach and a user-friendly game interface, the SIGMA intervention offers a significant contribution to the development of a cost-effective and preventive self-help tool for young overweight adults with maladaptive eating habits. TRIAL REGISTRATION: ISRCTN, ID: 70907354 . Registered on 6 February 2017. The ISRCTN registration is in line with the World Health Organization Trial Registration Data Set. The present paper represents the original version of the protocol. Any changes to the protocol will be communicated to ISRCTN.


Assuntos
Bulimia/terapia , Terapia Cognitivo-Comportamental/métodos , Medicina Baseada em Evidências , Exercício Físico , Comportamento Alimentar , Hábitos , Sobrepeso/terapia , Autocuidado/métodos , Telemedicina/métodos , Jogos de Vídeo , Adaptação Psicológica , Fatores Etários , Bulimia/diagnóstico , Bulimia/fisiopatologia , Bulimia/psicologia , Telefone Celular , Protocolos Clínicos , Cognição , Terapia Cognitivo-Comportamental/instrumentação , Fissura , Emoções , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Aplicativos Móveis , Sobrepeso/diagnóstico , Sobrepeso/fisiopatologia , Sobrepeso/psicologia , Projetos de Pesquisa , Romênia , Autocuidado/instrumentação , Telemedicina/instrumentação , Fatores de Tempo , Resultado do Tratamento , Perda de Peso
12.
Clin Nutr ESPEN ; 18: 55-58, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29132739

RESUMO

BACKGROUND & AIMS: Several questionnaires to screen for eating disorders have been validated in Malaysia. However, these tools are lengthy, and require specialist interpretation. The sick, control, one stone, fat, food (SCOFF) is easy to administer by non-specialists, but has not been validated in Malaysia. Therefore, the aim of our study was to validate the SCOFF on a non-clinical sample of tertiary students to determine if it could identify individuals with an eating disorder. METHODS: We recruited second year tertiary students from five faculties in a university in Malaysia, from June-November 2014, who could understand English. The SCOFF and the EAT-26 were administered at baseline. Two weeks later, the SCOFF was re-administered to assess for reliability. RESULTS: A total of 292 students were approached, and all agreed to participate (response rate = 100%). There was moderate correlation between the total SCOFF score with the EAT-26's dieting domain (spearman's rho = 0.504, p < 0.001), bulimia and food preoccupation domain (spearman's rho = 0.438, p < 0.001), and total score (spearman's rho = 0.483, p < 0.001). The internal consistency of the SCOFF was low (Cronbach alpha = 0.470). At retest, kappa scores ranged from 0.211 to 0.591. The sensitivity of the SCOFF was 77.4%, and its specificity was 60.5%. The positive predictive value was 18.9%, and its negative predictive value was 95.8%. CONCLUSIONS: The SCOFF was found to have adequate convergent validity and stable reliability. However, its internal consistency was low. The SCOFF can still be used in clinical practice. However, its positive results should be interpreted with caution due to its low positive predictive value.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Estudantes , Inquéritos e Questionários , Adolescente , Adulto , Anorexia Nervosa/diagnóstico , Anorexia Nervosa/prevenção & controle , Bulimia/diagnóstico , Bulimia/prevenção & controle , Transtornos da Alimentação e da Ingestão de Alimentos/prevenção & controle , Feminino , Humanos , Malásia , Masculino , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Universidades , Adulto Jovem
13.
Eat Weight Disord ; 22(3): 527-533, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28780748

RESUMO

PURPOSE: Food addiction (FA) refers to a condition characterized by addiction in relation to some high-fat and high-sugar carbohydrate that leads to clinically significant impairment or distress on several areas of functioning. The Yale Food Addiction Scale 2.0 (YFAS 2.0) has been recently updated to measure FA according to the DSM-5 criteria for substance-related and addictive disorders. This study aimed at validating the Italian version of YFAS 2.0. METHODS: A sample of 574 Italian university students was involved in this research. Confirmatory Factor Analysis (CFA) and Kuder-Richardson's alpha for dichotomous data were run to evaluate scale structure and reliability. Correlations between YFAS 2.0 and eating psychopathology, binge eating, sleep, and mood symptoms were evaluated. RESULTS: Analogously to the original version, a single factor structure emerged at the CFA. The alpha coefficient was 0.87. Moreover, sound, from moderate to high, correlations were found with other measures. CONCLUSIONS: The Italian version of the YFAS 2.0 has demonstrated in a sample of university students to be a useful tool to investigate food addictions. Level of evidence Level V, descriptive study.


Assuntos
Bulimia/diagnóstico , Dependência de Alimentos/diagnóstico , Adolescente , Comportamento Alimentar , Feminino , Humanos , Itália , Masculino , Psicometria , Reprodutibilidade dos Testes , Traduções , Adulto Jovem
14.
J Psychol ; 151(4): 379-392, 2017 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-28388342

RESUMO

Given the clinical usefulness of the CFQ-BI (Cognitive Fusion Questionnaire-Body Image; the only existing measure to assess the body-image-related cognitive fusion), the present study aimed to confirm its one-factor structure, to verify its measurement invariance between clinical and non-clinical samples, to analyze its internal consistency and sensitivity to detect differences between samples, as well as to explore the incremental and convergent validities of the CFQ-BI scores in Brazilian samples.  This was a cross-sectional study, which was conducted in clinical (women with overweight or obesity in treatment for weight loss) and non-clinical samples (women from the general population). The one-factor structure was confirmed showing factorial measurement invariance across clinical and non-clinical samples. The CFQ-BI scores presented an excellent internal consistency, were able to discriminate clinical and non-clinical samples, and were positively associated with binge eating severity, general cognitive fusion, and psychological inflexibility. Furthermore, body-image-related cognitive fusion scores (CFQ-BI) presented incremental validity over a general measure of cognitive fusion in the prediction of binge eating symptoms. This study demonstrated that CFQ-BI is a short scale with reliable and robust scores in Brazilian samples, presenting incremental and convergent validities, measurement invariance, and sensitivity to detect differences between clinical and non-clinical groups of women, enabling comparative studies between them.


Assuntos
Imagem Corporal/psicologia , Bulimia/psicologia , Psicometria/métodos , Adolescente , Adulto , Bulimia/diagnóstico , Cognição , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Inquéritos e Questionários , Adulto Jovem
15.
Clín. salud ; 28(1): 1-8, mar. 2017. graf, ilus
Artigo em Espanhol | IBECS | ID: ibc-160903

RESUMO

Se analiza el caso de un varón que acude a consulta por problemas de consumo de alcohol, bulimia y descontrol generalizado. Los resultados obtenidos muestran un cumplimiento total de los objetivos de intervención planteados. El objetivo de este artículo es identificar, en un caso de tanta complejidad, cuáles son los procesos subyacentes al cambio terapéutico que explican el éxito alcanzado en un número tan reducido de sesiones. A partir de este análisis se plantea la hipótesis de que algunos de los factores que podrían explicar dicho éxito estén relacionados con la adaptación tanto de las técnicas de intervención como del discurso del terapeuta a las variables disposicionales y funcionales del cliente


This paper presents the case study of a man treated for alcohol addiction, bulimia, and a generalized lack of control. The results obtained show full compliance with the objectives established for the intervention. The aim of this article is to explain, in a case of such complexity, which were the underlying processes that allowed for the therapeutic change to take place in such a small number of sessions. From this analysis it is hypothesized that some of the factors that could explain this success are related to the adaptation of the intervention techniques, such as the therapist’ discourse, and to the client's dispositional and functional variables


Assuntos
Humanos , Masculino , Adulto , Alcoolismo/complicações , Alcoolismo/diagnóstico , Alcoolismo/terapia , Bulimia/complicações , Bulimia/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Alcoolismo/psicologia , Comportamento Alimentar/fisiologia , Comportamento Alimentar/psicologia , Vômito/complicações
16.
Compr Psychiatry ; 74: 118-124, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28160693

RESUMO

BACKGROUND: Food addiction has been widely researched in past years. However, there is a debate on the mechanisms underlying addictive eating and a better understanding of the processes associated to these behaviors is needed. Previous studies have found characteristic psychological correlates of food addiction, such as high negative urgency, emotion regulation difficulties and low self-directedness, in different samples of adults with addictive eating patterns. Still, it seems difficult to disentangle effects independent from general eating disorder psychopathology. Therefore, this study aimed to test a comprehensive model under control of eating disorder severity, in order to find independent predictors of food addiction. METHODS: 315 patients with eating disorder diagnoses on the binge-eating spectrum were assessed in personality, emotion regulation, negative urgency, eating disorder symptomatology, and food addiction by self-report. Hypothesis-driven structural equation modeling was conducted to test the comprehensive model. RESULTS: The only independent predictor found for food addiction was negative urgency, while self-directedness and emotion regulation predicted negative urgency and were highly related to eating disorder symptomatology, but not to food addiction. CONCLUSIONS: Altogether the model suggests that low self-directedness and difficulties in emotion regulation are related to higher eating disorder symptomatology in general. Those patients who, in addition to these traits, tend to act impulsively when in negative mood states, are at risk for developing addictive eating patterns. Urgency-based treatments are therefore recommended for this subgroup of patients.


Assuntos
Comportamento Aditivo/diagnóstico , Comportamento Aditivo/psicologia , Transtorno da Compulsão Alimentar/diagnóstico , Transtorno da Compulsão Alimentar/psicologia , Emoções , Comportamento Alimentar/psicologia , Adulto , Bulimia/diagnóstico , Bulimia/psicologia , Feminino , Humanos , Masculino , Personalidade , Autorrelato
17.
Am J Med ; 130(7): 846-855, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28213045

RESUMO

BACKGROUND: Uncovering the correct diagnosis of chronic hypokalemia with potassium (K+) wasting from the kidneys or gut can be fraught with challenges. We identified clinical and laboratory parameters helpful for differentiating the causes of chronic hypokalemia. METHODS: Normotensive patients referred to our tertiary academic medical center for the evaluation of chronic hypokalemia were prospectively enrolled over 5 years. Clinical features, laboratory examinations-including blood and spot urine electrolytes, acid-base status, biochemistries, and hormones-as well as genetic analysis, were determined. RESULTS: Ninety-nine patients with chronic normotensive hypokalemia (serum K+ 2.8 ± 0.4 mmol/L, duration 4.1 ± 0.9 years) were enrolled. Neuromuscular symptoms were the most common complaints. Although Gitelman syndrome (n = 33), Bartter syndrome (n = 10), and distal renal tubular acidosis (n = 12) were the predominant renal tubular disorders, 44 patients (44%) were diagnosed with anorexia/bulimia nervosa (n = 21), surreptitious use of laxatives (n = 11), or diuretics (n = 12). Patients with gastrointestinal causes and surreptitious diuretics use exhibited a female predominance, lower body mass index, and less K+ supplementation. High urine K+ excretion (transtubular potassium gradient >3, urine K+/Cr >2 mmol/mmol) was universally present in patients with renal tubular disorders, but also found in >50% patients with gastrointestinal causes. Of interest, while urine sodium (Na+) and chloride (Cl-) excretions were high and coupled (urine Na+/Cl- ratio ∼1) in renal tubular disorders and "on" diuretics use, skewed or uncoupled urine Na+ and Cl- excretions were found in anorexia/bulimia nervosa and laxatives abuse (urine Na+/Cl- ratio: 5.0 ± 2.2, 0.4 ± 0.2, respectively) and low urine Na+ and Cl- excretions with fixed Na+/Cl- ratios (0.9 ± 0.2) when "off" diuretics. CONCLUSION: Besides body mass index, sex, and blood acid-base status, integrated interpretation of the urine Na+:Cl- excretion and their ratio is important to make an accurate diagnosis and treatment plan for patients with chronic normotensive hypokalemia.


Assuntos
Hipopotassemia/etiologia , Acidose Tubular Renal/complicações , Acidose Tubular Renal/diagnóstico , Adulto , Anorexia Nervosa/complicações , Anorexia Nervosa/diagnóstico , Síndrome de Bartter/complicações , Síndrome de Bartter/diagnóstico , Índice de Massa Corporal , Bulimia/complicações , Bulimia/diagnóstico , Cloretos/urina , Doença Crônica , Diuréticos/efeitos adversos , Feminino , Síndrome de Gitelman/complicações , Síndrome de Gitelman/diagnóstico , Humanos , Hipopotassemia/urina , Laxantes/efeitos adversos , Masculino , Estudos Prospectivos , Fatores Sexuais , Sódio/urina , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/diagnóstico
18.
BMC Psychiatry ; 17(1): 19, 2017 01 17.
Artigo em Inglês | MEDLINE | ID: mdl-28095885

RESUMO

BACKGROUND: Very little is known about the prevalence of ADHD symptoms in Bulimia Nervosa and Binge Eating Disorder and even less in other eating disorders. This knowledge gap is of clinical importance since stimulant treatment is proven effective in Binge Eating Disorder and discussed as a treatment possibility for Bulimia Nervosa. The objective of this study was to explore the prevalence and types of self-reported ADHD symptoms in an unselected group of eating disorder patients assessed in a specialized eating disorder clinic. METHODS: In total 1165 adults with an eating disorder were assessed with a battery of standardized instruments, for measuring inter alia ADHD screening, demographic variables, eating disorder symptoms and psychiatric comorbidity. Chi-square tests were used for categorical variables and Kruskal-Wallis tests for continuous variables. RESULTS: Almost one third (31.3 %) of the patients scored above the screening cut off indicating a possible ADHD. The highest prevalence rates (35-37 %) were found in Bulimia Nervosa and Anorexia Nervosa bingeing/purging subtype, while Eating Disorder Not Otherwise Specified type 1-4 and Binge Eating Disorder patients reported slightly below average (26-31 %), and Anorexia Nervosa restricting subtype patients even lower (18 %). Presence of binge eating, purging, loss of control over eating and non-anorectic BMI were related to results indicating a possible ADHD. Psychiatric comorbidity correlated to ADHD symptoms without explaining the differences between eating disorder diagnoses. CONCLUSIONS: There is a high frequency of ADHD symptoms in patients with binge eating/purging eating disorders that motivates further studies, particularly concerning the effects of ADHD medication. The finding that the frequency of ADHD symptoms in anorexia nervosa with binge eating/purging is as high as in bulimia nervosa highlights the need also for this group.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Adolescente , Adulto , Anorexia Nervosa/diagnóstico , Anorexia Nervosa/epidemiologia , Anorexia Nervosa/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtorno da Compulsão Alimentar/diagnóstico , Transtorno da Compulsão Alimentar/epidemiologia , Transtorno da Compulsão Alimentar/psicologia , Bulimia/diagnóstico , Bulimia/epidemiologia , Bulimia/psicologia , Bulimia Nervosa/diagnóstico , Bulimia Nervosa/epidemiologia , Bulimia Nervosa/psicologia , Estudos de Coortes , Comorbidade , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Feminino , Humanos , Masculino , Motivação , Estudos Prospectivos , Suécia/epidemiologia , Adulto Jovem
19.
Int J Eat Disord ; 50(4): 389-397, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27991694

RESUMO

Targeted approaches for the treatment of severe and enduring anorexia nervosa (SE-AN) have been recommended, but there is no consensus definition of SE-AN to inform research and clinical practice. This study aimed to take initial steps toward developing an empirically based definition of SE-AN by characterizing associations among putative indicators of severity and chronicity in eating disorders. Patients with AN (N = 355) completed interviews and questionnaires at treatment admission and discharge; height and weight were assessed to calculate body mass index (BMI). Structural equation mixture modeling was used to test whether associations among potential indicators of SE-AN (illness duration, treatment history, BMI, binge eating, purging, quality-of-life) formed distinct subgroups, a single group with one or more dimensions, or a combination of subgroups and dimensions. A three-factor (dimensional), two-profile (categorical) mixture model provided the best fit to the data. Factor 1 included eating disorder behaviors; Factor 2 comprised quality-of-life domains; Factor 3 was characterized by illness duration, number of hospitalizations, and admission BMI. Profiles differed on eating disorder behaviors and quality-of-life, but not on indicators of chronicity or BMI. Factor scores, but not profile membership, predicted outcome at discharge from treatment. Data suggest that patients with AN can be classified on the basis of eating disorder behaviors and quality-of-life, but there was no evidence for a chronic subgroup of AN. Rather, indices of chronicity varied dimensionally within each class. Given that current definitions of SE-AN rely on illness duration, these findings have implications for research and clinical practice.


Assuntos
Anorexia Nervosa/diagnóstico , Transtorno da Compulsão Alimentar/diagnóstico , Bulimia/diagnóstico , Comportamento Alimentar/psicologia , Adolescente , Adulto , Anorexia Nervosa/psicologia , Transtorno da Compulsão Alimentar/psicologia , Índice de Massa Corporal , Peso Corporal , Bulimia/psicologia , Bulimia Nervosa , Ingestão de Alimentos/psicologia , Feminino , Humanos , Masculino , Prognóstico , Qualidade de Vida , Índice de Gravidade de Doença , Inquéritos e Questionários , Adulto Jovem
20.
Soins Psychiatr ; 37(307): 15-19, 2016.
Artigo em Francês | MEDLINE | ID: mdl-27890269

RESUMO

Comorbidity with a borderline personality disorder is far from rare in patients suffering from eating disorders. Clinically, this presents as chronic instability in many areas: interpersonal relationships, self-image, emotions, mood and acting out. Treatment is mainly based on a containing and reassuring therapeutic framework. A care plan may be put in place that incorporates reducing impulsive harmful, eating and self-harming behaviours. Dialectical behaviour therapy is intended in particular to prevent suicide risk in borderline personality disorder patients.


Assuntos
Anorexia Nervosa/enfermagem , Anorexia Nervosa/psicologia , Transtorno da Personalidade Borderline/enfermagem , Transtorno da Personalidade Borderline/psicologia , Apego ao Objeto , Transtorno Reativo de Vinculação na Infância/enfermagem , Transtorno Reativo de Vinculação na Infância/psicologia , Encenação , Anorexia Nervosa/diagnóstico , Anorexia Nervosa/epidemiologia , Comportamento Aditivo/diagnóstico , Comportamento Aditivo/epidemiologia , Comportamento Aditivo/enfermagem , Comportamento Aditivo/psicologia , Transtorno da Personalidade Borderline/diagnóstico , Transtorno da Personalidade Borderline/epidemiologia , Bulimia/diagnóstico , Bulimia/epidemiologia , Bulimia/enfermagem , Bulimia/psicologia , Terapia Combinada/enfermagem , Comorbidade , Feminino , Hospitalização , Humanos , Masculino , Terapia Ambiental , Relações Enfermeiro-Paciente , Prognóstico , Transtorno Reativo de Vinculação na Infância/diagnóstico , Transtorno Reativo de Vinculação na Infância/epidemiologia , Fatores de Risco
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