A Relational Cultural Approach to Working With Clients With Eating Disorders

The authors examine eating disorders through the conceptual framework of relational cultural theory (RCT). Taking into account the importance of relationships and connection, it is suggested that RCT may be a useful lens for conceptualizing and working with people who are experiencing eating disorders. Ways that RCT can be applied to enhance prevention efforts and recommendations for combining relationally focused counseling with evidence‐based individual eating disorder treatment are presented.     

College Atmosphere and Eating Disorders

The authors investigated whether different campus environment factors were related to eating disorder symptomatology at two distinctly different colleges. The first campus was conservative, placing an emphasis on appearance and dress, whereas the second campus was liberal, placing an emphasis on political activism and intellectual talent. As hypothesized, the two schools did not differ in regard to overall levels of eating disorders, yet different factors were associated with eating disorder symptomatology at each school. Implications for eating disorder interventions on college campuses are discussed.     

Disorders of Eating in the Elderly

The most common eating disorder in the elderly in both community and hospital settings is food refusal. This may lead to weight loss and malnutrition with all the adverse consequences on independence and function. The management of disorders of eating in the elderly is a diagnostic and therapeutic challenge, requiring the combined skills of the medical and nursing staff. The causes are often multifactorial and require careful and repeated assessment of the patient's social, psychological, and medical history. Approach to treatment involves these factors, as well as ethical and cultural considerations. Eating is the most basic biological drive for survival in nature. In human societies there are additional cultural and social aspects that may override this instinct, as in the case of hunger strikes for political motives. In the elderly, food is one of the major sources of possible pleasure and it is the challenge for health providers to try and give this enjoyment to their patients for as long as possible.     

进食障碍亚临床状态的概念及诊断

自编异常进食行为问卷对南京地区703名青少年进行调查,通过分析80名高分被试出现的共同症状来界定进食障碍亚临床状态的概念和诊断。研究揭示,界定亚临床状态,要综合考察个体对身体的态度,体重,异常进食行为出现的频率、持续时间和严重程度等指标。     

The Children of Mothers with Eating Disorders

There is good evidence that children of parents with psychological disorders are themselves at increased risk of disturbances in their development. Although there has been considerable research on a variety of disorders such as depression and alcohol, research on the children of parents with eating disorders has been relatively recent. This paper aims to review the evidence and covers a number of areas, including genetic factors, pregnancy, the perinatal and postpartum period, infancy, and the early years of life, focusing on feeding and mealtimes, general parenting functions, and growth. This is followed by a consideration of psychopathology in the children, parental attitudes to children's weight and shape, and adolescence. What is clear is that although there are numerous case reports and case series, the number of systematic controlled studies is relatively small, and almost nothing has been written about the children of fathers with eating disorders. What is evident from the available evidence is that children of mothers with eating disorders are at increased risk of disturbance, but that the risk depends on a variety of factors, and that difficulties in the children are far from invariable. The paper concludes by summarizing five broad categories of putative mechanisms, based on the evidence to date, by which eating disturbance in parents can influence child development.     

A Review of Eating Disorders in Athletes

SUMMARY

The current review aims to evaluate the literature on eating disorders and athletes with the purpose of making recommendations for sport psychologists and other relevant personnel on how to proceed in identifying, managing, and preventing eating disorders in school settings. Whereas the intention of this review is to make recommendations for secondary educational settings, research on other populations such as collegiate and young adult athletes was also reviewed where helpful or where information on adolescent athletes was not available. Recommendations for prevention and intervention include ongoing education of athletes and coaches regarding nutrition, body composition, and performance, using appropriate screening to detect eating disorders, and use of a sport management team to aid in athlete recovery.     

Eating Ethically: 'Spiritual' and 'Quasi-religious' Aspects of Vegetarianism

Much contemporary belief and behaviour that is not ostensibly religious has yet been perceived to have religious overtones. A variety of terms such as 'invisible religion', 'implicit religion' and 'quasi-religion' have been used to characterise them. This article examines vegetarianism and especially vegetarianism based upon ethical concerns in order to ascertain the extent to which it can be said to exhibit religious or spiritual themes in its ideology and underlying motives. A number of 'quasi-religious' themes, including taboo and avoidance behaviour, reverence for life, the denial of death, reincarnation, observance of disciplines and the rejection of domination and oppression are found to characterise ethical vegetarianism. Support for these conclusions is found in the data from a survey of vegetarians carried out in the Reading area of South Eastern England, of which some results are presented and discussed. The article concludes with a discussion of the appropriateness of using concepts such as 'quasi-religion'. It is argued that although such terms are currently useful, they must in the longer term be replaced by concepts which do not imply that such behaviour is a form of religion or which characterise it always in relation to religion, but which recognise its own distinctive and essentially non-religious character.     

Eating Disorders in Men: Current Considerations

Over the past two decades, there has been a change in the way men think about their bodies. The media portrays images of men with muscular bodies and a six pack abdomen. These images can create body dissatisfaction in males. With the change in the way that the media and society in the United States look at men, so has the drive for men to achieve this ideal body image. Eating disorders, body dysmorphia, and strict exercise and diet regimens seem to plague young men as do the images in advertisements. Although eating disorders in men are similar to what women experience, men seem to strive for more body mass whereas women try to obtain thinness. Gay men and heterosexual men seem to experience eating disorders in the same way although there are differences between how they perceive their bodies. This paper outlines how the media contributes to body dissatisfaction in men. In addition to understanding how the media affects men, it is important to review and possibly revise out understanding of eating disorders and body dysmorphia symptoms to gain a solid understanding of how these symptoms appear in men today.     

进食障碍发病机制的研究进展与思考

进食障碍是一组典型而严重的心身疾病.随着现代医学模式的转变,生物-心理-社会因素对进食障碍的影响日益受到关注.本文拟从生物学、心理学、社会学因素方面,综述近年来国内外对进食障碍发病机制的最新研究,并结合哲学相关理论对进食障碍发病机制的研究进行探讨分析.     

Using Student Paraprofessionals in the Treatment of Eating Disorders

A rationale for adjunctive treatment in responding to eating disorder clients at a university counseling center is presented. The program described provides a highly structured internship experience for paraprofessional psychology trainees who serve as therapeutic aides and peer counselors to eating disorder clients. This collaborative Counseling Center and Psychology Department model emphasizes intern training, close supervision, and professional-paraprofessional cotreatment of anorexic and bulimic clients. Program evaluation methods and therapy outcome data are presented. Advantages of this treatment-training program for all participants are discussed.     

The Semantics of Power Among People With Eating Disorders

The study aimed to empirically test the hypothesis, developed within the systemic-constructionist theory of family semantic polarities, that the semantics of power are particularly meaningful for people with eating disorders. The repertory grid technique was used to elicit constructs from 30 young patients (10 anorexic, 10 bulimic, and 10 obese) and from a matched control group; the two sets of constructs were compared in terms of their semantic content. Overall the results confirmed the hypothesis, although further investigation into the semantic peculiarities of individual eating disorders is required. Methodological limitations and possible clinical applications are discussed.     

Early Onset Binge Eating and Purging Eating Disorders: Course and Outcome in a Population-Based Study of Adolescents

This study aimed to describe the course of early onset eating disorders in a population-based sample followed from 14 to 20 years; identify variables that could account for the persistence of eating disorders from 14 to 20 years; and describe outcome of early onset eating disorders with reference to general and psychological functioning at age 20. Participants (N?=?1,383; 49 % male) were drawn from the Western Australian Pregnancy Cohort (Raine) Study, which has followed children from pre-birth to young adulthood. Eating disorder symptoms were assessed using an adapted version of the Eating Disorder Examination-Questionnaire, at ages 14, 17 and 20. At age 14, 70 participants met DSM-IV criteria for a binge eating or purging eating disorder. Nearly half (44 %) of these adolescents ceased to meet criteria for an eating disorders at ages 17 and 20, whilst one-quarter still met criteria for an eating disorder at age 20 and one-fifth met criteria for an eating disorder at all three time points. Purging at age 17 and externalising behaviour problems at age 14 were the strongest predictors of eating disorder persistence to age 20. Participants who experienced a persistent eating disorder were less likely to complete high school than other participants, and reported pronounced depressive and anxiety symptoms at age 20. This study provides new data the course and outcome of early onset eating disorders at a population level. Behavioural difficulties in early adolescence and purging in middle adolescence may predict persistent eating pathology to young adulthood.     

Health-Related Quality of Life in Women with Eating Disorders: Association with Subjective and Objective Binge Eating

This study examined health-related quality of life (QOL) and its association with different forms of binge eating in 53 women with eating disorders. Participants had enrolled in treatment for anorexia nervosa, bulimia nervosa, binge eating disorder, or other eating disorders not otherwise specified and completed measures of QOL, eating-related psychopathology, and mood disturbance. Eating- and mood-related psychopathology, and to a lesser extent, mental-component QOL scores, were severely impaired in this sample relative to population norms. QOL was significantly and independently predicted by subjective bulimic episodes and compensatory behaviors, including food avoidance, laxative abuse, and self-induced vomiting, accounting for 32% of the variance. Subjective bulimic episodes and food avoidance also independently predicted the physical-component QOL, accounting for 27% of the variance. These findings suggest that subjective bulimic episodes may be independently associated with impairment in QOL and may require specific attention as targets of treatment.     

The Eating Disorders Inventory Among Asian American College Women

Abstract

The authors examined the effects of social support and self-control in a representative sample of 300 older adults in high-density households in an urban area of Agra City, India. The authors administered the Social Support Questionnaire (I. G. Sarason, H. M. Levine, R. B. Basham, &; B. R. Sarason, 1983) and the Self-Control Schedule (M. Rosenbaum, 1980) to form a 2 (age group: young-old vs. old-old) × 2 (social support: high vs. low) × 2 (self-control: high vs. low) factorial design. Scores on the Life Attitude Profile (G. T. Recker &; E. J. Peacock, 1981) and the Perceived Control Scale (P. Nayyar, 1993) were the dependent variables. The authors hypothesized that social support and self-control would act as moderators for a more positive attitude toward life and increased perceived control. The results supported the predictions: Social support and self-control in interaction with age reduced the crowding stress of high density and enhanced the older participants' perceived control and positive attitudes toward life.