Eating disorder and obsessive–compulsive symptoms in a sample of bulimic women: Perfectionism as a mediating factor

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.     

Do children with autism recognise surprise? A research note

Abstract

We take a fresh look at emotion recognition in autistic children, by testing their recognition of three different emotions (happy, sad, and surprise). The interest in selecting these is that whereas the first two are typical “simple” emotions (caused by situations), the third is typically a “cognitive” emotion (caused by beliefs). Because subjects with autism have clear difficulties in understanding beliefs, we predicted they would show more difficulty in recognising surprise. In contrast, as they have no difficulty in understanding situations as causes of emotion, we predicted they would not show deficits in recognising happy and sad. These predictions were borne out, in a comparison with a group of normal children and in a group of subjects with mental handicap. This result shows the importance of fine-grain analysis in emotion-recognition tasks, and is discussed in relation to affective and theory of mind models of autism.     

Overvaluation of shape and weight among overweight children and adolescents with loss of control eating

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.     

A Triage Tool to Assess Unmet Health Needs for Children Entering Foster Care

Children in foster care have high levels of health care needs, many of which are unmet at foster care entry. Health care coordination (HCC) is essential to ensure unmet needs are addressed rapidly. Data is lacking about how best to triage children at foster care entry so limited HCC resources can be allocated most effectively. Therefore, we aimed to: (1) utilize a Triage Tool (TT) at foster care entry to stratify children based on unmet health care needs and (2) determine if the TT is an accurate predictor of health care utilization as indicated by cost during a child’s first few weeks in care. A TT was developed and utilized during the initial foster care health exam (IFCHE) to stratify children based on unmet needs. Medicaid records were reviewed to determine health care utilization and cost during the first 60 days post-IFCHE. Most children (61.6%) had the lowest level of unmet needs (Level 3), 29.5% had a moderate level of unmet needs (Level 2), and 9.9% had the highest level of unmet needs (Level 1). Medicaid claims review revealed that triage level did not correlate to health care utilization or costs during the first 60 days post-IFCHE. Youth placed in a group home incurred significantly higher costs than those placed in foster homes. These results suggest that the TT is useful clinically but does not predict health care utilization and costs during the first weeks in care. Group home placement incurs more cost than foster home placement, independent of triage level assigned.