Scham und Familienbeziehungen bei Bulimie

Background

Empirical studies show a relationship between family factors and disturbed eating behavior. Feelings of shame are associated with a higher level of eating disorder symptoms and with family relations perceived as being dysfunctional. Thus shame can be understood as a mediator of the relationship between dysfunctional family relations and eating disorder symptoms.

Material and methods

For 69 female patients, including 55 with bulimia nervosa and 14 with eating disorder not otherwise specified (EDNOS) between 14 and 22 years of age, who participated in a comparative study of psychotherapy outcome, eating disorder symptoms (EDI, EDE-Q), general psychiatric symptoms severity (SCL-90R), level of shame (TESE-KJ) and perceived family relations (FB-A) were measured at the beginning of psychotherapy.

Results

The higher the feeling of shame the more dysfunctional the perceived family relationships were and the more the eating disorders and general symptoms severity were reported. Shame was a partial mediator of the relationship between family functionality and symptoms.

Discussion

Feelings of shame could originate in dysfunctional family relationships but could also evoke more negative perceptions of interpersonal relationships. The direction of causality could not be proven in the correlative design; nevertheless, shame contributes to an understanding of the mechanisms between dysfunctional family relationships and eating disorder symptoms.     

ON LOSS AND MELANCHOLY: AN AUTOBIOGRAPHICAL ESSAY

One of the dominant motifs by social scientists dealing with issues of loss assumes an upsetting of balance or equilibrium as central to the experience - an upsetting that is in need of "restoration." This article challenges that motif both theoretically and experientially, drawing on autobiographical narrative to navigate the complex terrain of irrevocable loss. Our story tells of the lives of our two children, Aristéa and Kade, and of Kade's death in the depths of a Romanian orphanage. We offer the concept of "melancholy" to suggest that the incongruity or pain that we feel, as a result of Kade's death and our simultaneous struggle to "save" Aristéa, can never be alleviated.     

Thomas Bradwardine on God and the Foundations of Modality

Scholars have claimed that the fourteenth-century thinker Thomas Bradwardine held that God's will freely determined what was necessary, possible and impossible and in this regard, he was a medieval precursor to Descartes. In this article, I argue against this interpretation of Bradwardine. I show that Bradwardine held that objects derive their modal status based on whether God's necessary and immutable being isrepugnant or non-repugnant to their existence. I offer readings of thepassages in which Bradwardine appears to state that God's will determines modality that render them consistent with the non-voluntarist interpretation of his modal theory.     

The Influence of Confirmation Bias on Memory and Source Monitoring

Two experiments were conducted to examine whether recognition memory for information and/or its source are influenced by confirmation bias. During Phase 1, subjects were shown a summary about the issue of gun control and asked to indicate a position on the issue. During Phase 2, 12 abstracts (Experiment 1) or social media posts (Experiment 2) were shown, one at a time. Posts in Experiment 2 were associated with either friends or strangers. Participants indicated whether they wanted to read a more extensive version of each abstract (Experiment 1) or post (Experiment 2). Phase 3 was the memory phase. Thirty-two abstract titles (Experiment 1) or posts (Experiment 2) were shown one at a time. Participants indicated yes or no, and whether they recognized the titles/posts from the last phase. Recognition memory for information that supported the participants' viewpoint was higher than that for opposing information.     

Studies of Family Relations Test Patterns: 1. Test Inhibition

An empirical investigation of Bene and Anthony's (1957) “tenderness vs. toughness” hypothesis of inhibition in boys was conducted. Examination of the Family Relations Test (FRT) protocols of 217 boys (age range, 7 years 2 months to 12 years 10 months; IQ range, 80 to 132) referred to Calgary School Board psychologists, showed Bene and Anthony's hypothesis to be valid in this sample. Evidence is given to suggest that each of the eight scoring categories should be viewed separately for inhibition trends and not summed over any of the three dimensions, intensity, direction, and valence. The relation of FRT Inhibition to reason for referral was examined but only in the eight-year-old group was any significant relationship found.     

Ethical Considerations in the Treatment of Compulsive Hoarding

Although empirically supported treatment for compulsive hoarding is in its preliminary stages, some information has emerged regarding ethical challenges experienced in treating this population. Our aims are twofold: (a) to inform the clinical community of ethical complications when conducting treatment for hoarding clients, and (b) to provide a decision-making model for ensuring quality and ethical care of hoarding clients. The ethical challenges (boundary crossings, dual roles, privacy/confidentiality, record keeping, fees, and cultural competence in treatment) were discovered through multiple roundtable discussions, supervision, and in the course of delivering empirically supported treatment protocols. A literature search was conducted to identify research that addressed ethical concerns. A decision-making model addressing ethical challenges in treatment of compulsive hoarding was developed.     

Perfectionism in depression, obsessive-compulsive disorder and eating disorders

High levels of perfectionism have been observed in major depression, anxiety disorders and eating disorders. Though few studies have compared levels of perfectionism across these disorders, there is reason to believe that different dimensions of perfectionism may be involved in eating disorders than in depression or anxiety [Bardone-Cone, A. M. et al. (2007). Perfectionism and eating disorders: Current status and future directions. Clinical Psychology Review, 27, 84-405]. The present study compared patients with major depression, obsessive-compulsive disorder, and eating disorders on dimensions of perfectionism. Concern over Mistakes was elevated in each of the patient groups while Pure Personal Standards was only elevated in the eating disorder sample. Doubts about Actions was elevated in both patients with obsessive-compulsive disorder and eating disorders, but not in depressed patients. Analyses of covariance indicated that Concern over Mistakes accounted for most of the variance in the relationship of perfectionism to these forms of psychopathology.     

Lay counselors: Thoughts on the crossing of ecological frameworks and the use of lay counselors in the scale up of early infant mental health interventions

The recent call for the scale-up of evidence-based early childhood development interventions, in lower and middle-income countries and for minority groups in high-income countries, has seen numerous suggestions to train greater numbers of lay mental health workers to fulfill these functions. While studies have found that concepts from developed country settings, such as attachment, parental sensitivity, and containment, find purchase and relevance within developing settings, the management of contextual and cultural factors and the tensions of cultural interfacing in the rollout of these programs in developing country settings require consideration. Drawing on the experiences of two successful South African mother–infant home-visiting programs as examples, this article discusses some of the challenges in provision of attachment-based infant mental health programs and highlights the need for careful consideration of a number of factors pertaining to the recruitment, supervision, and management of lay mental health workers before large-scale rollout is conducted.