An Outline of Literature Findings

By Dena Thompson

I. Article: Level of anxiety connected with putting on weight as a predictor of bulimia and anorexia (Basiaga-Pasternak & Czekaj, 2009)

a. Possible Causes of Eating Disorders

1. Fear of obesity

2. Psychological problems

b. Weaknessess of Article:

1. How competitive are the universities?

2. Food could be an issue based on level of competitiveness

3. Do gender and culture play a role?

Causes of eating disorders explained

Depression, low self-esteem, incresed lability and

intensity

No acceptance of ones appearance, demanding

mother, anxiety

II. Article: Primary prevention of

eating disorders (Shisslak, Crago, N

eal & Swain, 1987, Octob

er)

a. Summary

Signs of anorexia-loss of 25% of body weight, hyperactivit

y, distorted body image, preoccupati

on with food

Signs of bulimia-Binge

eating, vomiting, purging

Physical problems in a person with anorexia include

heart, kidney, menstrual problems

Bulimics have electrolyte

imbalances, menstrual and gastric

problems

The Personality Of An Anorexic1. A perfectionist2. Someone who is compliant3. Introverted4. Stubborn

The Personality of a Bulimic1. More extroverted than anorexics2. Impulsive behaviors

The Family Of An Anorexic or BulimicOverprotective

Prefer conflict avoidancePsycho pathology is more prevalent in family members

The family does not value self-esteemThe family does not value self-efficacy

Three Types Of Prevention For Eating Disorders:

1. Primary- focuses on reducing the incidence of a disorder.2. Secondary- focuses on early diagnoses and reducing the incidence.3. Tertiary interventions- reduces the impairment

Signs A Child Could Have An Eating Disorder

What A Girl Should Know At The Junior High Level1. Be more aware of her body 2. Understand that natural changes occur3. The components of maturation4. Be willing to discuss food, emotions, and diet5. Peer group leaders could discuss the ideal body and healthy ways to achieve a healthy body

What A Young Woman Should Know At The Senior Level1. Consequences of eating disorders2. The role of women in society3. How women are portrayed4. Stereotypes

What Can Be Done At The Family Level? 1. Efforts can be made starting in pre-school2. Parents need to be role models for their children by eating the right foods (Tager, 1982)What Can Be Done At The Community Level?1. Extreme eating and thinness should be discussed2. Gyms and grocery stores could present information on eating disorders.3. Prevention programs need better assessment

Strengths and Weaknesses1. Signs and risk factors explained2. Prevention was discussed at different levels3. Outcome could have been discussed more

III. Article: Weight eating syndrome presenting as anorexia in an athlete: Case report and review (Trojan, 2009 July/Aug)Night eating syndrome (NES) can be associated with bulimia nervosa or dissociative disorders which affects 1.5% of the population

Signs of NES1. Late night eating 2. Waking several times at night to eat3. Being bloated and tired in the morning 4. Insomnia

Strengths

1. Explained NES2. The 14 item questionnaire as a screening tool for diagnosis3. Explained that the problem can be controlled with medication4. The article recognized the symptoms of NES

Weakness 1. The drug sertraline was not discussed as to whether it could be used for all eating disorders.2. Side effects needed to be explained

StrengthsA two-tailed Fisher exact test was used to make a comparison between Meal Support Therapy Patients and patients on Naso-gastric feeding.Continuous variables were tested using an independent two-tailed t-test.

WeaknessesSmall sample sizeThe nature of the study design

Article: The Prevalence of Eating Disorders in Adolescents with Idiopathic Scoliosis (Alborghetti et al., 2008 Jan/Feb)

Summary

Somatic diseases which are correlated with eating disorders

idiopathic scoliosis

diabetes

cystic fibrosis

Crohn’s disease

hyper or hypothyroidism

HOW DOES A PERSON PSYCOLOGICALLY FEEL WITH A SPINAL DEFORMITY OR PHYSICAL CONDITION?

Signs of idiopathic scoliosis and eating disorderslow body mass index

poor eating habits

Tests to confirm the hypothesis:1. binomial probability test to test correlation between AIS and eating disorders2. one-way ANOVA test to test severity of AIS in relation to ED

Strengths: Informative in regards to how diseases could lead to eating disorders and stress

The experiment had several hypothesis

A thorough assessment can be made of problems

WEAKNESSES:-No longitudinal study-An eating disorder could be unrelated to AIS

VI Article: Is there a relationship between parental self-reported psychopathology and symptom severity in adolescents with anorexia nervosa (Ravi, Forsberg, Fitzpatrick & Lock, 2009 Jan/Feb)?

SummaryPsychopathology in parents and anorexia nervosa in adolescents are they related in some way?-Based on a symptom check list they could be

The Symptom Check List For Parents1. Anxiety2. Depression3. Obsessive compulsive behaviors4. Hostility

These are factors which contribute to anorexia nervosa

I. Eating disorder examinationa. Four subscales

1. Shape concerns2. Weight concerns3. Eating concerns4. Restraint subscale

How can parental psychopathology be measured?-One tailed test and a Spearman rank order correlations

RESULTSOut of 60 AN’s 55 mothers and 48 fathers with a t score greater than 65 mothers depressive symptoms were 20% and 20.9% for fathers Depression is the highest percentage for parents with a child who has AN.

-There is a correlation between parental psychopathology and the severity of AN.-A one-tailed test, and a Spearman’s rank order correlation test was used to determine a correlation between parental psychopathology and the severity of AN.-Parental psychopathology is greater than in the community when a child has AN

-The control was not clearly defined.-The data could support the hypothesis through a better design.-A longer study could be done studying parental psychopathology.-Psychiatric history in parents is not considered before a child is diagnosed with AN.-The study has a small sample size.-There was no well defined control group.-It would be interesting to see how a family functions when a person has AN so that better interventions could be created

VII Article: Integration of oral health care and mental health services: Dental hygienists’ readiness and capacity for secondary prevention of eating disorders (DiGioacchino DeBate et al., 2006 Mar).

Summary:A cross-sectional study can integrate oral and mental health.

Eating disorder associations:1. Tooth erosion2. Tooth sensitivity3. Dry mouth

Physical Problems:1. Loss of hair from not eating right2. Growth of fine body hair3. Weight changes4. Parotid gland enlargement (bulimia nervosa)5. Erosion of the fingernail from induced vomiting (bulimia nervosa)

How can a better outcome occur?1. Early identification2. Referral and treatment3. Dentists and dental hygienists recognize the health problem first 4. Dental check-ups every 6 months5. Secondary prevention practices

Strengths:I. Stresses readiness as a prevention strategy

a. Degree of readiness1. Identification of oral problems2. Showing concern for the patient3. Patient specific home dental care4. Arranging frequent dental visits5. Referral 6. Case management

II. Stresses capacity as a prevention strategya. Capacity

1. Considerations should be made towards intrapersonal perceptions.

2. Considerations should be made towards modifying factors(eg. self-efficacy).

Weakness of the article:

Some factors did not effect criterion-specific behavior which include knowledge of physical cues for AN and perceived severity of AN

VIII Article: Perceived incompetence moderates the relationship between maladaptive perfectionism and disordered eating (Ferrier-Auerbach & Martens, 2009 Jul-Sep)

Summary:I. What is associated with eating disorders?

a. Maladaptive perfectionism1. Procrastinating2. Fearing failure3. Avoiding failure4. Having inflexible high standards5. Believing that one should excel6. Perceived incompetence

Strengths of article:1. Article was reviewed by a review board 2. The surveys were kept confidential.3. Missing data was accounted for by using expectation maximization procedures and regression coefficients.4. Hierarchal regression analysis was used. 5. There is a greater correlation between perceived incompetence and eating disorders.6. Maladaptive perfectionism together with perceived incompetence=disordered eating

THE WEAKNESSES OF THE STUDY1. The answers to the surveys could be false.

2. The article could have done a better job at discussing the different domains of perceived incompetence.

IX Article: A pilot study of a family-based treatment for adolescent anorexia nervosa: 18-and 36-month Follow-ups (Paulson-Karlsson et al., 2009 Jan/Feb)

SummaryFamily based treatment reduces eating disorder symptoms by 75%.The “Maudsley model” could be an effective way to treat adolescents with AN.Outcomes include clear diagnostic criteria with a follow-up study.

Strengths

The study met the six criteria for a good outcome.

Weaknesses

Small sample size

The follow-up periods were short.

The treatment is not 100% effective.

X. Article: A randomized experimental test of the efficacy of eye movement desensitization and reprocessing (EMDR) treatment on negative body image in eating disorder inpatients (Bloomgarden & Calogero, 2008 Oct-Dec)

Summary:Standard residential therapy + eye movement desensitization and reprocessing = better outcome by reducing negative body image of themselves. However, it is unclear if combining standardize residential therapy (SRT) and EMDR could help other symptoms of an eating disorder.

Article Analysis Strengths

Psychotherapeutic treatment stresses negative body image as the leading factor in eating disorders.

Aversive

Not associated with secondary gain

Treatment=less negative body image memories

Weaknesses

Inaccuracy of memory recall of negative body image memories because memories fade.

A broader comparison of treatment conditions should be made.

Contamination effect

Diagnosis not represented in final sample

Facts to know about anorexia and bulimia:

1. High morbidity2. High mortality rate3. Eating disorders are harder to treat when a person has a physical illness in which monitoring food is crucial.

HypothesisCan factors of maladaptive perfectionism, perceived incompetence and parental psychopathology lead to a 90 percent chance of children developing an eating disorder, depression or anxiety?

References

Alborghetti, A., Scimeca, G., Costanzo, G., & Stefano, B. (2008, January/February). The

Prevalence of Eating Disorders in Adolescents with Idiopathic Scoliosis. Eating Disorders,

Vol.16 Issue 1, 85 9p. Retrieved from SPORTDiscus with Full Text (AN 28111295)

ANAD. (2011). Title. National Association of Anorexia and Associated Disorders. Retrieved

March 7, 2011, from http://www.anad.org/get-information/about-eating-disorders/eating-disorders-statistics/

Basiaga-Pasternak, J., & Czekaj, S. (2009). Level of anxiety connected with puffing on weight as

a predictor of bulimia and anorexia. Physiotherapy, Vol.17 Issue 3, 36 5p. Retrieved from

(AN 52489357)

Bloomgarden, A., & Calogero, R. (2008, Oct-Dec). A randomized experimental test of the

efficacy of EMDR treatment on negative body image in eating disorder inpatients. Eating

Disorders, Vol. 16 Issue 5, 418 10p. Retrieved from SPORTDiscus with Full Text (AN

34506315)

Coker, L. (2010, January 20). Jenny Kirk on figure skating’s eating disorder epidemic (Part 1).

The Huffington Post.com, Inc. Retrieved March 7, 2011, from

http://www.huffington.com/lesleyann-coker/jenny-kirk-on-figure-skat_b_430032.html

Couturier, J., & Mahmood, A. (2009, Jul-Sep). Meal support therapy reduces the use of

nasogastric feeding for adolescents hospitalized with anorexia nervosa. Eating Disorders Vol.

17 Issue 4, 327 6p. Retrieved from SPORTDiscus with Full Text (AN 42120674)

DiGioacchino DeBate, R., Plichta, S., Tedesco, L., Kerschbaum, W. (2006, March). Integration

of oral health care and mental health services: Dental Hygienists’ Readiness and Capacity for

Secondary Prevention of Eating Disorders. Journal of Behavioral Health Services &

Research; Vol.33 Issue 1, 113-125, 13p, 5 charts. Retrieved from Psychology and Behavioral

Sciences Collection (AN 23101048)

Ferrier-Auerbach., Amanda, G., & Martens, M. (2009, Jul-Sep). Perceived incompetence

moderates the relationship between maladaptive perfectionism and disordered eating.

Eating Disorders, Vol. 17 Issue 4, 333 12p. Retrieved from SPORTDiscus with Full Text (AN

42120673)

References Continued

Le Grange, D. (2005, October). The Maudsley family-based treatment for adolescent anorexia nervosa. World Psychiatry Official Journal of the World Psychiatric Association. World Psychiatry, 4 (3), 142-146. Retrieved from http:://www.ncbi.nlm.nih.gov/pmc/articles/PMC1414759/

Martin, J. (2010, March 13). 5 Models who died from eating disorders. Mademan Manual.Retrieved March 7, 2011, from http://www.mademan.com/mm/5-models-who-died-eating-disorders.html

Paulson-Karlsson, G., Engstrom., I., & Nevonen, L. (2009, Jan/Feb). A pilot study of a family-based treatment for adolescent anorexia nervosa: 18- and 36-month follow-ups. Eating Disorders, Vol. 17 Issue 1, 72 17p. Retrieved from SPORTDiscus with Full Text (AN 35818007)

Ravi, S., Forsberg, S., Fitzpatrick, K., & Lock, J. (2009, Jan/Feb). Is there a relationship between parental self-reported psychopathology and symptom severity in adolescents with anorexia nervosa? Eating Disorders, Vol. 17 Issue 1, 63 9p. Retrieved from SPORTDiscus with Full Text (AN 35818008)

Shisslak, C., Crago, Marjorie., Neal, Mary E.., Swain, Barbara. (1987, October). Journal of Consulting and Clinical Psychology, 55.5: 660-667. Retrieved from ProQuest Central (AN 00085993)

Trojian, T., Jow, V. (2009, July/August). Night eating syndrome presenting as anorexia in an athlete: Case report and review. Current Sports Medicine Reports, Vol.8 Issue 4, 182. Retrieved from SPORTSDiscus with Full Text (AN 43478362)