Transdiagnostic Theory and Application of Family-Based Treatment for Youth with Eating Disorders

This paper describes the transdiagnostic theory and application of family-based treatment (FBT) for children and adolescents with eating disorders. We review the fundamentals of FBT, a transdiagnostic theoretical model of FBT and the literature supporting its clinical application, adaptations across developmental stages and the diagnostic spectrum of eating disorders, and the strengths and challenges of this approach, including its suitability for youth. Finally, we report a case study of an adolescent female with eating disorder not otherwise specified (EDNOS) for whom FBT was effective. We conclude that FBT is a promising outpatient treatment for anorexia nervosa, bulimia nervosa, and their EDNOS variants. The transdiagnostic model of FBT posits that while the etiology of an eating disorder is unknown, the pathology affects the family and home environment in ways that inadvertently allow for symptom maintenance and progression. FBT directly targets and resolves family level variables, including secrecy, blame, internalization of illness, and extreme active or passive parental responses to the eating disorder. Future research will test these mechanisms, which are currently theoretical.     

Associative and categorical relations in the associative memory illusion

What kinds of associations underlie the associative memory illusion? In Experiment 1, lists composed of horizontal, or coordinate, free associates elicited false recognition of critical lures much more often than did lists composed of vertical, or subordinate, category instances. Experiment 2 replicated this result, and showed that the difference between free associates and category instances was not an artifact of differential levels of forward or backward associative strength. Associative structure plays an important role in the associative memory illusion: The illusion is strongest when the critical lure lies at the same level of categorization as the studied items.     

A parapraxis in a dream

When a parapraxis is put on display in a dream, one can only wonder what service the willful mistake is rendering to resourceful dream work. Freud taught us that anything that appears in the manifest content of a dream may well be a disguise or a distortion of a subject that originally made an anxiety-provoking, and hence short-lived, first appearance in latent dream thoughts. Dreams in dreams and jokes in dreams have been examined from this perspective (Mahon 2002a, 2002b), and this paper focuses on the appearance and meaning of a parapraxis in a dream, with the argument that seemingly casual "mistakes" are highlighted in the manifest display to cover up some latent, much more deliberate subject matter.     

Loneliness and health-related variables in early adolescents: an extension

The purpose of this study was to extend knowledge about loneliness and health-related variables. In classrooms, 135 early adolescents responded to measures of loneliness, symptom patterns, and perceived health status. Statistically significant correlations were found for loneliness scores with ratings for symptom patterns (.44) and with ratings for perceived health status (-.46).     

Pharmacologic treatment of body dysmorphic disorder: review of the evidence and a recommended treatment approach

Research on effective pharmacotherapy for body dysmorphic disorder (BDD) has rapidly increased in recent years, with emerging data consistently indicating that serotonin reuptake inhibitors (SRIs) are often efficacious for this disorder. Although data are limited, it appears that higher SRI doses and longer treatment trials than those used for many other psychiatric disorders are often needed to treat BDD effectively. Approaches to treatment-resistant BDD have received little investigation, but available data indicate that switching to another SRI and several SRI-augmentation strategies may be helpful. This article reviews the empirical literature on BDD and offers a recommended approach to the pharmacotherapy of this distressing and often disabling disorder.     

Prediction of psychological reactions to bone density screening for osteoporosis using a cognitive-behavioral model of health anxiety

Pre-screening measures derived from a cognitive-behavioral theory of health anxiety were significant predictors of individual differences in post-screening reactions to a health screening procedure, bone densitometry. Predictors included specific illness beliefs (vulnerability, severity/consequences, coping and treatment) and general health anxiety measures. Three months after a low bone mineral density (BMD) result, women with high levels of pre-existing general health anxiety gave higher ratings of anxiety about osteoporosis and perceived likelihood of developing osteoporosis than women with low levels of preexisting health anxiety, even though the two groups' initial ratings had not differed significantly. Women with a low BMD result generally showed "minimization" of the seriousness of low BMD but women with very high levels of pre-existing health anxiety did not. After a high BMD result, highly health anxious women were only temporarily reassured. The results were consistent with the cognitive-behavioral analysis of health anxiety.     

The neurobiology of virtual reality pain attenuation.

During the past decade, virtual reality (VR) has gained recognition as a means of attenuating pain during medical procedures. However, while investigators have examined the effects of virtual environments on level of distraction, subjective pain intensity, and brain activity, there have been only a handful of investigations into the neurobiological mechanisms associated with VR's efficacy. In an effort to explain how VR may alter pain perception and produce analgesia, as well as to guide the development of novel and improved VR pain treatments, this review aims to link the wealth of empirical data examining the neurobiology of pain to the growing field of VR. This review is separated into three main sections: (a) a brief overview of the current literature on the use of VR for the treatment of pain; (b) a review of the basic neurobiology of how pain is detected, processed, and controlled by the brain; and (c) an exploration into how current VR pain treatments may impact the pain system to produce analgesia. In addition, the future of VR for pain treatment is discussed, including how current treatments might be improved and novel ways to use VR to treat pain might be developed. Speculation on future VR interventions is based on our current understanding of how the brain processes pain and how VR appears to alter this process and produce analgesia.