Browsing by Subject "Anorexia Nervosa"

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Acute Treatment Outcomes and Family Functioning of Children and Adolescents Diagnosed with Anorexia Nervosa
(2006-08-11) Hetrick, Maryann O.; Kennard, Beth D.
Recent studies have suggested that there is a relationship between treatment outcomes and baseline factors related to family functioning and specific eating disorder symptoms. However, these relationships have not been studied extensively within a pediatric population hospitalized for treatment. Therefore, it is unknown whether these relationships exist within an acutely ill population and whether these baseline characteristics improve significantly immediately following acute hospitalization. Given these limitations, the aims of the present study were to identify aspects of family functioning and eating cognitions and attitudes at admission that predict outcome at discharge, and evaluate what aspects of family functioning and eating cognitions and attitudes improve during an acute treatment period. The sample consisted of 41 patients diagnosed with anorexia nervosa or eating disorder not otherwise specified between the ages of 10 and 17 years. At admission, all patients were administered a structured clinical interview to obtain valid psychiatric diagnoses. Additionally, patients completed self-report measures of eating cognitions, eating attitudes, and family functioning; while parents completed a self-report measure of family functioning. Families also participated in a standardized clinician-rated observational measure of family functioning. All measures were re-administered at discharge, and the patient's body mass index (BMI) at admission and discharge were obtained from the medical record. The attrition rate from intake to discharge for this study was 26.8%. Overall, it appeared that parents and patients perceived their families to be healthy at intake, with little improvements noted over the course of treatment. However, standardized observations characterized these families as being affectively avoidant. Additionally, parental perception of adaptive family functioning at intake was predictive of outcome based upon the unit psychiatrist's assessment, and patient perception of healthy familial Expressiveness at intake was predictive of outcome based upon pathological eating attitudes. BMI and eating attitudes based upon eating behavior during treatment improved significantly over the course of treatment. However, patients continued to endorse unhealthy eating cognitions at discharge. These results suggest that weight restoration and pathological eating behavior are the first symptoms to improve during an aggressive treatment period, and psychological symptoms may require a longer period of treatment to remit.
Anorexia nervosa
(1965-09-30) Unknown
Mediators of Weight Gain in Acute Treatment of Patients with Anorexia Nervosa
(2009-06-18) Rosckes, Jacqueline Whitney; Stewart, Sunita M.
Anorexia Nervosa has been associated with low levels of readiness to recover since the earliest accounts of the disorder. Given the motivational deficiency and egosyntonic quality, anorexia nervosa is among the most difficult types of psychological disorders to treat. Recent empirical and theoretical investigations have focused on the long-term outcome of weight gain from readiness to change. However, few studies have analyzed the bidirectional relationship of readiness to change and weight gain during the course of hospitalization. The aims of the present study were to analyze the short-term bidirectional relationship between readiness to change and weight gain at multiple time points during acute hospitalization, and to evaluate the influence of stronger cognitive distortions at admission on the relationship between recent weight gain and readiness to change. The sample consisted of 30 females and 3 males diagnosed with anorexia nervosa, bulimia nervosa, or eating disorder not otherwise specified, with weight below 93 percent of their healthy weight range, and who were admitted to an inpatient facility. At admission, the patients were administered self-report measures assessing readiness to change and cognitive distortions. Additionally, patients completed a self-report measure evaluating readiness to change every two weeks following admission. This study found that during the last weeks of hospitalization, readiness to change predicted weight gain one day following the completion of the self-report measure. However, despite the expectation that greater prior weight gain would predict lower readiness to change, no such relationship emerged. Additionally, the severity of cognitive distortions at admission was not found to predict a stronger negative relationship between prior weight gain and readiness to change. These results suggest that readiness to change can be utilized to predict short-term weight gain at multiple time points during the latter part of hospitalization for treatment of anorexia nervosa. This information has implications for the clinical care of severely underweight patients with eating disorders.
The Relationship Between Maternal Psychopathology and Acute Treatment Outcomes of Children and Adolescents Diagnosed With Anorexia Nervosa
(2006-08-11) Spector, Sarah Melissa; Kennard, Beth D.
Recent studies have suggested that maternal psychopathology influences the psychiatric status of children. However, there is a lack of research in the eating disorder literature pertaining to the impact of maternal psychopathology, specifically related to depression and eating disordered cognitions, on a child or adolescent diagnosed with anorexia nervosa. Therefore, this study investigated the relationship between maternal psychopathology and eating disorders. Specifically, this study examined the relationship between maternal eating disordered cognitions and depression and severity of child's psychopathology, as well as the relationship between maternal eating disordered cognitions and acute treatment outcomes of a child or adolescent diagnosed with anorexia nervosa. The sample consisted of 43 children and adolescents between the ages of ten and seventeen years of age, with a diagnosis of anorexia nervosa or eating disorder not otherwise specified. All subjects were being treated at Children's Medical Center psychiatric unit as an inpatient or partial hospitalization patient. At entry to treatment, all patients were administered a structured clinical interview to obtain comprehensive psychiatric diagnoses. Additionally, subjects and their mothers or female caregivers completed self-report measures of eating disordered cognitions and depressive symptomatology. The relationship between maternal psychopathology, child eating disordered psychopathology, and relationship to treatment outcome was assessed. Results revealed a significant relationship between maternal depressive symptoms and the severity of the child's eating disordered cognitions. However, despite the expectation that the degree of maternal eating disordered cognitions at admission would predict the child's outcome over an acute period of treatment, no significant relationship was found. Results from this study suggest that maternal depression may play a more influential role in the child's eating disorder psychopathology than maternal eating disordered cognitions.
Sibling Relationships in Adolescent Eating Disorder Treatment
(August 2021) Parides, Ashlyn Alyce; Ghannadpour, Jasmine; Stewart, Sunita M.; Pollard, Sara; McDonald, Wade; McGarrahan, Andrew
This study explored the quality of sibling relationships amongst a sample of adolescent patients receiving treatment for an eating disorder. Despite the importance of siblings in adolescents' lives and the utilization of family-based treatment (FBT) as the gold standard treatment, sibling relationships are often overlooked. When sibling relationships have been investigated in the literature, the story has been one-sided, with patient perspectives being omitted. We sought to understand, through the eyes of the patient, the overall quality of the sibling relationship on four factors: warmth/closeness, relative status/power, conflict, and rivalry, and ways in which the onset of the eating disorder changed the relationship regarding these four factors. Of particular interest was discovering specific behaviors, interactions, and aspects of the sibling relationship that patients felt contributed, either negatively or positively, to their eating disorder and recovery efforts. We also hoped to provide patients the opportunity to share ideas or suggestions that could better support their recovery efforts. Methods: Semi-structured individual interviews (N = 14) were completed with adolescent patients. Data were analyzed using a hybrid inductive and deductive approach and thematic content analysis. Results: After the onset of the eating disorder, participants expressed decreased warmth and closeness, increased conflict, and increased competition for family resources. Siblings were often one of the first in patients' lives to suspect the eating disorder. Helpful aspects included greater understanding of their siblings' condition and increased ability to relate to their siblings' struggles, sibling motivation, and involvement in treatment. Comparison, competition, and invalidating or triggering comments were unhelpful. Patients suggested implementation of sibling education and increased involvement in treatment. A common thread throughout this study is the patients' desire to be fully seen, heard, and understood, which they identify to be a critical aspect of achieving recovery. Conclusions: Findings illustrate the importance of sibling relationships among adolescents receiving treatment for an eating disorder. We demonstrate that siblings can be important resources in prevention and early identification efforts. We echo the voices of our patients and advocate for increased sibling education and sibling involvement in treatment, in hopes that our efforts can better support these patients and their families in their journey to recovery.