Changes in body image during cognitive-behavioral treatment in women with bulimia nervosa

The purposes of this study were: (1) to examine multidimensional aspects of body image of individuals with bulimia nervosa (BN) at pre-treatment, post-treatment, and at follow-up, compared to a group of participants without BN; and (2) to investigate whether measures of body image predicted outcome at post-treatment and follow-up. The clinical sample consisted of 109 females with BN who were enrolled in a 12-week cognitive-behavioral group treatment program. Participants were assessed at baseline, at the completion of treatment, and at 1- and 6-month follow-up visits. The 82 females who comprised the non-bulimic sample were assessed at comparable time intervals. At baseline, the participants with BN reported greater body dissatisfaction and overestimated body size to a significantly greater degree than the comparison group, and reported a significantly smaller ideal size relative to perceived size. Results at the end of treatment indicated significant improvement in self-reported attitudinal disturbance and size overestimation, with continued reductions at follow-up. Logistic regression analyses did not demonstrate a predictive relationship between body image measures at baseline and outcome at post-treatment or follow-up, or between post-treatment and follow-up. Implications for treatment include specifying the source of body image-related distress and enhancing treatment efforts for perceptual and attitudinal aspects of body image.     

Educational risk factors for psychological truancy in Lesotho: a qualitative exploration

A qualitative case study design was used to explore educational risk factors that may contribute to psychological truancy in a Lesotho secondary school. Purposively sampled teachers (n = 4, females = 50%) and pupils (n = 4, females = 75%), who have experience of psychological truancy, took part in a focus group and individual interviews. Inductive content analysis was used to analyse data emanating from the interviews. The findings indicate that pupil–teacher relationships, the use of English as medium of instruction and a lack of resources may be educational risk factors contributing to psychological truancy. Positive pupil–teacher relationships and active classroom engagement are prerequisites for successful and active learning.     

A Reliability Generalization Study of Coefficient Alpha for the UCLA Loneliness Scale

The goal of this investigation was the development of an Inconsistency scale (ICN–SF) for the Personality Assessment Inventory–Short Form (PAI–SF). In Study 1, 503 inpatient profiles were randomly assigned to a derivation or cross-validation sample. Ten correlated item pairs were identified using the derivation sample and placed on the ICN–SF. Psychometric properties of the ICN–SF total scores were comparable in the derivation and cross-validation samples. Total ICN–SF scores in both samples were significantly lower than scores obtained from computer-generated random samples. Diagnostic efficiency statistics are reported using multiple cut-off scores at various base rate estimates. ICN–SF scores greater than 8 reasonably balanced sensitivity and specificity rates. This cutoff correctly classified 92% of the random protocols and inaccurately classified 9% of the patient protocols in Study 1. In Study 2, PAI–SF scores from 627 forensic and civil inpatients produced similar results, effectively identifying cases with elevated scores on the full-form Inconsistency scale. Overall the results of both studies suggest that the ICN–SF can aid examiners in assessing for inconsistent responding.     

Relation of Family Size to Intelligence of Offspring and Socio-Economic Status of Family

Abstract

Barbara S. Burks, D. W. Jensen, &; Lewis M. Terman. Genetic studies of Genius: Vol. 3. The promise of youth; follow-up studies of a thousand gifted children. Stanford University, Calif.: Stanford Univ. Press, 1930. Pp. xiv+508. $6.00.     

Examining School Attachment,Social Support,and Trauma Symptomatology Among Court-Involved,Female Students

Court-involved youth (i.e., youth in the foster care and/or juvenile justice systems), and particularly those in residential placement facilities, often present with trauma histories that can impede various areas of development and functioning. These traumatic histories can negatively impact academic performance and school success, leading to poorer outcomes later in life. In particular, female youth in these systems exhibit unique responses to traumatic experiences that further complicate healthy development. This study assesses female, court-involved students (n?=?141), exploring the relationship between school attachment and school involvement, school social support (from peers, teachers, and other staff), and trauma symptomatology among a sample of residential placement students exposed to a trauma-informed teaching intervention over the course of a school year. It was hypothesized that higher school attachment/involvement and social support would be associated with lower student trauma symptomatology. As expected, findings demonstrated that students in the sample had experienced high trauma exposure, as indicated by their high trauma symptomatology. Unexpectedly, they also had high school attachment. Furthermore, higher school attachment was associated with lower trauma symptoms among students. On the other hand, students reported lower levels of social support from classmates, which was associated with significantly higher trauma symptomatology. Implications for future research are addressed.     

Ecological momentary assessment of bulimia nervosa: Does dietary restriction predict binge eating?

The purpose of this study was to examine the relationship between caloric restriction (CR) and binge eating (BE) using ecological momentary assessment (EMA). Participants included 133 women with bulimia nervosa (BN) who completed an EMA protocol for 2 weeks. Logistic regression analyses tested whether CR increased the probability of BE episodes. The results revealed that the odds of BE increased on the day that restriction occurred as well as on the following day. In addition, both restriction and BE on one day predicted the likelihood of BE the subsequent day, but restriction for two days prior to the episode failed to add additional information for predicting BE. These findings support the cognitive behavioral therapy (CBT) model of BN, suggesting that self-reported dietary restriction is predictive of subsequent BE episodes, and that reducing dietary restriction in treatment may lead to improvements in bulimic symptoms.     

Screening for eating disorders in primary care: EDE-Q versus SCOFF

OBJECTIVE AND METHODS: The comparative validity of the Eating Disorder Examination Questionnaire (EDE-Q) (22 items) and SCOFF (five items) in screening for cases of the more commonly occurring eating disorders was examined in a primary care sample of young adult women (n=257). Diagnoses were confirmed in a sub-group of interviewed participants (n=147). RESULTS: Twenty-five cases, primarily variants of bulimia nervosa (BN) not meeting formal diagnostic criteria, were identified in the interviewed sample. An EDE-Q global score of >or= 2.80 yielded the optimal trade-off between sensitivity (Se) (0.80) and specificity (Sp) (0.80) (positive predictive value (PPV)=0.44), whereas a score of two or more positive responses on the SCOFF was optimal (Se=0.72, Sp=0.73, PPV=0.35). Validity coefficients for both measures varied as a function of participants' age and body weight, although these effects were more pronounced for the SCOFF. CONCLUSIONS: Both measures performed well in terms of their ability to detect cases and to exclude non-cases of the more commonly occurring eating disorders in a primary care setting. The EDE-Q performed somewhat better than the SCOFF and was more robust to effects on validity of age and weight. These findings need to be weighed against the advantage of the SCOFF in terms of its brevity.     

Incidence of suicidal ideation and behavior in the United States, 1994.

Completed suicides reflect only a portion of the impact of suicidal behavior; sublethal behaviors cause morbidity and can signal treatable problems such as depression. There is no national quantification of nonlethal suicidal behaviors. The present study used a random-digit-dialed telephone survey to estimate the 12-month incidence of suicidal ideation, planning, and attempts among U.S. adults. Of 5,238 respondents, 5.6% (representing about 10.5 million persons) reported suicidal ideation, 2.7% (about 2.7 million) made a specific suicide plan, and 0.7% (about 700,000) made a suicide attempt (estimate = 1.1 million attempts). Hence, suicidal behaviors are not uncommon and occur along a continuum ranging from ideation to completed suicides. Preventing nonlethal precursor behaviors may prevent deaths.     

There is no moral authority in medicine: response to Cowdin and Tuohey.

Central to the Cowdin-Tuohey paper is the concept of a moral authority proper to medical practitioners. Much as I agree with the authors in refusing to degrade doctors to the status of mere technicians, I argue that one does not succeed in retrieving the moral dimension of medical practice by investing doctors with moral authority. I show that none of the cases brought forth by Cowdin-Tuohey really amounts to a case of moral authority. Then I try to explain why no such cases can be found. Developing an insight that is common to all the major moral thinkers in the philosophia perennis, I show that doctors are professionally competent with respect only to a part of the human good; morally wise persons are competent with respect to that which makes man good as man. I try to show why it follows that a) professional expertise has no natural tendency to pass over into moral understanding, and that b) doctor and non-doctor alike start from the same point in developing their understanding of medical morality. It follows that the authors fail in their attempt to de-center the moral magisterium of the Church by setting up centers of moral authority outside of the Church.