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Objective: Mediators of treatment for family‐based treatment are explored for outcomes among adolescents with bulimia nervosa (BN). Method: Using data from a recently completed randomized clinical trial (RCT) comparing family‐based treatment (FBT) to supportive psychotherapy (SPT) we examined possible mediators of treatment outcome. Results: Results suggest that FBT‐BN was more effective than SPT in producing remission by virtue of achieving greater reductions in eating disorder psychopathology by mid‐treatment. Specifically, reductions in cognitions related to BN as assessed by the EDE appeared to be the differentiating mechanism. Conclusion: It is reasonable to hypothesize that change in the EDE subscales mediates outcome for FBT‐BN. Future studies with sufficient power to examine this possibility as an a priori hypothesis would help to better understand how FBT‐BN works and may also help to guide future treatment refinement and development.  相似文献   
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The present study aimed to investigate whether perfectionism mediates the association between obsessive–compulsive (OC) and eating disorder (ED) symptoms. Analyses were conducted using data collected among a national sample of eating disordered women diagnosed with BN or a subclinical variant of BN (N = 204). Each participant completed a series of self-report inventories on perfectionism, as well as OC, ED, and depressive symptoms. Higher ED symptoms were significantly associated with greater levels of perfectionism (p < .01) and OC symptoms (p < .05). As hypothesized, perfectionism significantly mediated the relationship between ED and OC symptoms, controlling for depression. Findings indicate that perfectionism may be considered a shared etiological or phenomenological factor in ED and OC symptoms.  相似文献   
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Little is known about the phenomenology of pediatric loss of control (LOC) eating. Overvaluation of shape and weight, however, appears to be diagnostically meaningful among binge eating adults. We explored the significance of shape and weight overvaluation among children and adolescents with LOC eating. Participants (n = 526) included 149 overweight youth with LOC eating and 377 overweight controls (CON). Participants were categorized as those reporting at least moderate overvaluation (LOC-Mod, n = 74; CON-Mod, n = 106) or less than moderate overvaluation (LOC-Low, n = 75; CON-Low, n = 271), and compared on measures of eating-related and general psychopathology. LOC-Mod evidenced lower self-esteem than CON-Low, and greater behavioral problems than CON-Mod and CON-Low, but did not differ from LOC-Low in these domains. With the exception of LOC-Low and CON-Mod, all groups differed on global eating-disorder severity, with LOC-Mod scoring the highest. Overvaluation of shape and weight appears to be of questionable importance in defining subtypes of youth with LOC eating. However, as overvaluation and LOC eating each independently predicts eating-disorder onset, their confluence may confer even further risk for eating-disorder development. Longitudinal studies should address this possibility. Developmentally appropriate discussion about body image disturbance may be indicated in interventions targeting pediatric LOC eating and/or obesity.  相似文献   
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In the last three decades, there has been an explosion in the frequency with which leaders of groups have issued official apologies for collective transgressions. These apologies are commonly assumed to lay a pathway to forgiveness and reconciliation, but empirical examination of the downstream consequences of collective apologies is still in its infancy. In this article, we review a series of studies—including interview studies, survey studies, and experiments—that question the assumed wisdom that collective apologies lead to intergroup forgiveness. Reasons for the muted evidence of an apology–forgiveness link at the intergroup level are elaborated, and implications for how best to issue gestures of reconciliation and remorse are discussed.  相似文献   
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We established a general genetic counseling clinic (GCC) to help reduce long wait times for new patient appointments and to enhance services for a subset of patients. Genetic counselors, who are licensed in Tennessee, were the primary providers and MD geneticists served as medical advisors. This article describes the clinic referral sources, reasons for referral and patient dispositions following their GCC visit(s). We obtained patients by triaging referrals made to our medical genetics division. Over 24 months, our GCC provided timely visits for 321 patients, allowing the MD geneticists to focus on patients needing a clinical exam and/or complex medical management. Following their GCC visit(s), over 80 % of patients did not need additional appointments with an MD geneticist. The GCC allowed the genetic counselor to spend more time with patients than is possible in our traditional medical genetics clinic. Patient satisfaction surveys (n?=?30) were very positive overall concerning the care provided. Added benefits for the genetic counselors were increased professional responsibility, autonomy and visibility as health care providers. We conclude that genetic counselors are accepted as health care providers by patients and referring providers for a subset of clinical genetics cases. A GCC can expand genetic services, complement more traditional genetic clinic models and utilize the strengths of the genetic counselor health care provider.  相似文献   
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