Browsing by Subject "Feeding and Eating Disorders"
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Item Characterizing Interpersonal Perception in Adolescent Eating Disorders(August 2021) Harper, Jessica Anne; McAdams, Carrie J.; Ghannadpour, Jasmine; Palka, Jayme; Kennard, Beth D.; McDonald, WadeEating disorders (EDs) are associated with significant morbidity and mortality, and recovery is a challenging and often protracted process. Improved understanding of EDs, including identification and refinement of treatment and recovery targets, is necessary to improve intervention and treatment outcomes. Cognitive and interpersonal models of EDs propose interpersonal function as a risk and maintenance factor, and the adult ED literature documents challenges in self-concept and interpersonal function during illness that improve with recovery. Adolescence is a significant period for social development as well as ED onset and early intervention. Despite this, little research has prospectively examined interpersonal perception as a potential target in adolescents. This observational study examined baseline differences in self-referential thinking in adolescents with EDs (n = 29) compared to healthy control adolescents (n = 31) using the Internal, Personal, and Situational Attributions Questionnaire self-report and a Social Identity behavioral task. Self-attribution bias was also examined prospectively as it related to both time and clinical symptoms in 25 ED and 30 HC. When controlling for depression severity, the ED group had a more negative self-attribution bias than the HC group (p = .006). Additionally, the ED group exhibited less positive self (p < .001), social (p = .015), and socially reflected appraisals (p = .011) but no group differences for friend and friend reflected appraisals during the Social Identity task. After including depression as a covariate, however, the model was no longer significant, suggesting group differences in social appraisals may be mediated by depression. Additionally, there was no significant effect of clinical symptoms on self-attribution bias, although more severe clinical symptoms were significantly associated with lower valence indices for self, social, and socially reflected appraisals. Although significant group differences remained for self-attribution bias at follow up, there was no effect for time or group × time, nor was there a relationship between self-attribution bias change and clinical symptom change. Findings support valence in self-perception as a potential target in adolescent EDs. Future research should replicate results in larger samples and include longer follow-up duration to clarify the relationship between self-attribution bias and clinical status in adolescents.Item [News](1983-05-10) Harrell, Ann; Rutherford, SusanItem [News](1983-09-28) Harrell, AnnItem [News](1984-10-30) Harrell, AnnItem Sibling Relationships in Adolescent Eating Disorder Treatment(August 2021) Parides, Ashlyn Alyce; Ghannadpour, Jasmine; Stewart, Sunita M.; Pollard, Sara; McDonald, Wade; McGarrahan, AndrewThis 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.Item Trust as a Predictor of Eating Disorder Severity and Therapeutic Alliance in an Adolescent Clinical Sample(2015-07-21) Krol, Heather Paige Lefkof; Stewart, Sunita M.; Latimer, Kelsey M.; McAdams, Carrie J.; Kelley, Urszula; Westers, NicholasTrust is recognized as an important construct across many disciplines. Despite this recognition, trust has proven difficult to define and measure, due to its abstract nature and variety of properties. Economic exchanges have become the standard measure of behavioral trust. A recent version, the "Trust Game," provides a unique opportunity to examine behavioral trust in an interactive, interpersonal situation. The Trust Game has been useful in demonstrating patterns of trust behavior in several psychiatric populations. Currently, the Trust Game has yet to be examined with adolescents suffering from eating disorders (EDs). These individuals are at high risk for deleterious outcomes, including an increased mortality risk, and thus early intervention and effective treatment are critical. Limited research exists on the role of trust in patients with EDs, and even less is known about the relationship of trust to factors important to treatment. The present study sought to address this gap in the literature by examining the relationship between behavioral trust and factors relevant to ED treatment, including attachment, self-reported trust, depression, ED severity, and the therapeutic alliance. This study also examined if behavioral trust predicts factors associated with treatment outcomes, including ED severity and therapeutic alliance, above and beyond depression. The sample consisted of 40 adolescents (ages 12-18) who were admitted to either inpatient or partial-hospitalization levels of care for an ED. Participants completed questionnaires and played the Trust Game with a computer simulated "healthy stranger." This pilot investigation found that behavioral trust was partially associated with attachment to parents, and only one aspect of the game related to self-reported trust. The results showed that higher overall game earnings explained unique variance in ED severity, after controlling for depression. Finally, this study found limited relationship between behavioral trust and the therapeutic alliance, although important aspects of the alliance were explored. The findings from this study increase our understanding of behavioral trust, as measured by the Trust Game, in adolescents with EDs and the relevance with factors important to the treatment of this population. Implications for clinicians, limitations of the methodology, and suggested areas for future research are discussed.Item [UT News](1986-10-24) Bosler, Tommy JoyItem [UT Southwestern Medical Center News](2006-04-04) McKenzie, Aline