Browsing by Subject "Eating Disorders"
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Item Anorexia nervosa - bulimia(1983-02-03) Foster, Daniel W.Item Indicators of Severity in Eating Disorders in Adolescents and the Effects on Rapidity of Weight Gain During Hospitalization(2010-01-12) Staub, Brittany Nicole; Stewart, Sunita M.Eating disorders are a very complex and serious psychiatric condition that require an ongoing commitment to a comprehensive treatment plan involving both medical and psychological intervention. Increases in the prevalence of this disorder, the high cost of hospitalization and the mounting rates of relapse have lead to increased pressure to identify and to understand predictive indicators of recovery. Though predictive variables have been identified in multiple studies, results are inconsistent and continue to focus on psychological measures; meanwhile disease-related variables are less frequently explored with regard to weight gain and more consistently reviewed in connection with long-term outcome. The primary aim of this study was to explore whether measures of severity at admission predicted rapidity of weight gain, or, more specifically, the length of time for a patient to achieve 85 percent of his or her ideal body weight. The sample consisted of 59 patients who were hospitalized for an eating disorder and who were admitted below 85 percent of their ideal body weight. Upon admission, patients completed self-report measures to assess depression and eating disorder symptomatology. Additionally, archival data concerning other measures of severity were gathered from patient medical charts. The study’s results suggest that the patient-reported intensity of eating disordered symptoms at admission are a significant predictor of length of time to reach 85 percent of ideal body weight. In future studies, researchers should utilize alternative measures of psychological functioning and eating disorder symptomatology, in addition to self-reports, to obtain more accurate predictors of severity.Item Psychological Variables Impacting Weight Gain Rapidity in Adolescents Hospitalized with Eating Disorders(2008-09-18) Phillips, Rachael Renee; Stewart, Sunita M.Eating disorders are associated with a variety of pervasive consequences and often necessitate immediate treatment that focuses on medical and psychological improvement. With the high cost of hospitalization, treatment facilities are experiencing increased pressure to quickly and effectively treat these disorders, though past studies have concluded that the psychological symptoms associated with eating disorders are slow to resolve. While there are multiple studies on outcome in eating disorder patients, very few studies have evaluated psychological variables as predictors of weight gain rapidity and duration of hospitalization among hospitalized adolescents. The aims of the present study were to identify what psychological variables at admission predicted rapidity of weight gain and duration of hospitalization and to evaluate what psychological variables improved during acute treatment. The sample consisted of 38 patients who were hospitalized for an eating disorder and were found to be below 93 percent of their healthy weight range. Upon admission, patients completed self-report measures assessing the following psychological variables: self-esteem, self-efficacy, perfectionism, readiness to change, emotion regulation, and cognitive distortions. Patients completed these measures again when reaching 85 percent of their ideal body weight (n = 29), if applicable, and once more upon discharge (n = 33). This prospective investigation revealed that self-efficacy, emotion regulation, and self-esteem at admission predicted time to reach 85 percent ideal body weight. Readiness to change at admission and, self-esteem at trend level, were predictive of duration of hospitalization. Several aspects of psychological functioning were found to significantly improve over the course of treatment, with readiness to change increasing and both perfectionism and cognitive distortions decreasing. Despite significant improvement in these psychological variables and in weight gain, no relationship was found between these changes. These results suggest that certain psychological factors can be utilized to predict weight gain x rapidity and duration of hospitalization for treatment of eating disorders. Additionally, there is significant improvement in both weight restoration and psychological functioning over the course of acute treatment. This information has important implications in identifying psychological severity of eating disorder, potential weight gain prognosis in treatment and determining specific treatment goals.Item The Role of Lateral Hypothalamic Neuropeptides in Drug Addiction and Feeding Behavior(2004-08-19) Georgescu, Dan; DiLeone, Ralph J.; Nestler, Eric J.; Bibb, James A.; Yanagisawa, MasashiA major goal of both feeding and drug abuse research is to understand the neural and molecular mechanisms that control intake and how dysfunction of these systems can lead to excessive food ingestion or addiction. Numerous studies have found synergistic effects of drugs of abuse and metabolism on reward related behaviors such as lateral hypothalamus self-stimulation (LHSS). The lateral hypothalamus (LH) is a brain structure with prominent roles in feeding, arousal and reward. Recent studies have found that melanin concentrating hormone (MCH), orexin A and orexin B are exclusively expressed in this brain area, opening the possibility that these LH neuropeptides could be involved in feeding behavior and drug addiction. This study shows that orexin neurons, and not the nearby LH neurons expressing MCH have 歯pioid receptors and respond with induction of cFos and CRE- mediated transcription to chronic morphine administration and opiate antagonist-precipitated morphine withdrawal. Additionally, orexin knockout mice and C57BL/6J mice that received a selective OX1R antagonist develop attenuated morphine dependence, as indicated by a less severe antagonistprecipitated withdrawal syndrome. These findings support a role for the orexin system in molecular adaptations to morphine, and demonstrate dramatic differences in molecular responses among different populations of LH neurons. This study also establishes a role for MCH and its receptor (MCH1R) in mediating a hypothalamic- limbic circuit that regulates feeding and related behaviors. Particularly intriguing was the high density of MCH1R in nucleus accumbens shell (AcSh), a region important in the regulation of appetitive behavior. Direct delivery of an MCH1R receptor antagonist to the AcSh blocked feeding and produced an antidepressant- like effect in the forced swim test, while intra-AcSh injection of MCH had opposite effects. Expression and biochemical studies demonstrated that MCH is modulating feeding behavior by interacting with the dopamine and glutamate pathways in the enkephalin and dynorphin positive neurons of AcSh. This work identifies a novel hypothalamic-AcSh circuit that may integrate the homeostatic and hedonic aspects of feeding. Together, these studies identify new roles for LH peptides in drug addiction, feeding and depression and help to define novel molecular mechanisms and neural circuits controlling complex behavior.Item The Use of an Observational Measure to Examine Family Characteristics in Children and Adolescents with Eating Disorders(2005-08-11) Housson, Wells Gibbons; Kennard, Beth D.This study evaluated families who had a child diagnosed with an eating disorder compared to those with a child diagnosed with depression. Both groups were assessed at entry to a treatment regime: the ED group was assessed upon admission to inpatient treatment for an eating disorder, and the MDD group was assessed at admission to a research study evaluating the use of psychotropic medication and therapy for children with MDD. The groups were compared on global family functioning as well as on specific aspects of family functioning. While the ED and MDD sample were similar in terms of ethnic breakdown, they did differ significantly in terms of age and gender, with the ED group being significantly older and having a significantly greater number of females than males. In this study, the MDD group and the ED group did not differ significantly in terms of global family competence on an observational measure of family competence, nor did they differ in terms of conflict or closeness. The inappropriate parent-child coalition subscale distinguished ED from MDD, with the ED families scoring in the more dysfunctional range on this subscale. Age was a significant predictor of this construct, such that the older the child, the less healthy the score on this subscale. Conflict did not distinguish the groups; however, severity of illness and gender (female) were significant predictors of healthier scores on the conflict subscale for the ED group. There were no significant predictors of conflict for the MDD group. The relationship between child report and rater observation of family functioning was assessed and found to be significant, such that there was a significant correlation between child self-report of overall family competence (Self-report Family Inventory) and rater observation (TCFES). The relationship between mother and child self-report of family functioning was also found to be significant, such that mothers and children in this study rated their families in a similar fashion. The relationship between maternal eating disordered cognitions and family functioning was not significant, nor was the relationship between mother and child report of eating disordered cognitions.