Factorial structure and diagnostic efficiency of DSM-IV criteria for avoidant personality disorder in patients with binge eating disorder

This study examined the factorial structure and diagnostic efficiency of the DSM-IV criteria for avoidant personality disorder (AVPD). Two hundred and twenty-eight consecutive outpatients (181 females and 47 males) with a primary diagnosis of binge eating disorder were reliably assessed with diagnostic interviews. Internal consistency of AVPD criteria was good, as suggested by coefficient alpha of 0.87, the pattern of inter-item correlations (range 0.41 to 0.64), and the lack of changes in alpha if any criteria are deleted. Exploratory factor analysis revealed a one-factor solution (56% of variance) supporting the unidimensionality of the AVPD criteria. Diagnostic efficiency indices (conditional probabilities, total predictive power, and kappa coefficients) were calculated for each AVPD criterion, for the entire study group and separately by gender. Overall, the best inclusion criterion was 'fears being ridiculed,' which was also the best predictor overall. These psychometric findings did not differ by gender. The findings support certain important aspects of the AVPD diagnosis.     

Patterns of Aberrant Eating Among Pre-adolescent Children in Foster Care

The paper reports epidemiological and phenomenological investigations of aberrant eating among 347 pre-adolescent children in court-ordered foster and kinship care, in New South Wales, Australia. A quarter of children displayed clinically significant aberrant eating problems, with no evidence of gender or age effects. Two distinct patterns were identified. The first is a pattern of excessive eating and food acquisition and maintenance behaviors without concurrent obesity (termed Food maintenance syndrome), resembling the behavioral correlates of Hyperphagic Short Stature (Psychosocial Dwarfism). Various data suggest this pattern is primarily triggered by acute stress, including maltreatment in care, against a background of complex psychopathology and developmental disabilities. The second is a cluster of pica-type eating behaviors that correlates with self-injurious behavior, and is closely associated with developmental disabilities. The paper includes recommendations for clinicians working with pre-adolescent children in care.     

Mindfulness and Acceptance in the Treatment of Disordered Eating

Mindfulness and acceptance-based approaches to the treatment of clinical problems are accruing substantial empirical support. This article examines the application of these approaches to disordered eating. Theoretical bases for the importance of mindfulness and acceptance in the treatment of eating problems are reviewed, and interventions for eating problems that incorporate mindfulness and acceptance skills are briefly described. Empirical data are presented from a pilot study of mindfulness-based cognitive therapy adapted for treatment of binge eating.     

Dieting behavior in Norwegian adolescents

In a sample of Norwegian adolescents (n = 1117) 27, 4% of the girls and 9% of the boys reported that they were dieting. Using multiple regression analyses, we were able to predict 50% of girls dieting behavior and 24% of boys dieting behavior. Psychological concerns relating to weight and eating (WEC) as well as perceptions of feeling fatter than others were the only significant predictors of dieting in girls, whilst dieting in boys could also be predicted by their Body Mass Index. Dieting girls who scored high on the Weight and Eating Concerns Inventory were found to suffer constipation and binge eating attacks more often than other dieting girls. This was taken as an indication that these girls were at risk of developing an eating disorder.     

从强迫运动到进食障碍症状:依恋的中介效应

目的:考察在校大学生依恋关系在强迫运动与进食障碍症状之间的中介效应。方法:研究一和研究二采用问卷调查法分别对466名男大学生和334名女大学生的依恋焦虑、依恋回避水平、强迫运动和进食障碍临床症状进行考察,通过分层回归检验依恋焦虑和依恋回避在强迫运动与进食障碍症状间的中介效应,并用Bootstrap法对中介效应进行验证。结果:在男女大学生中强迫运动可显著预测进食障碍症状; 在男生当中,依恋的两个维度依恋焦虑和依恋回避在强迫运动与进食障碍间的部分中介作用显著; 在女生当中,仅依恋焦虑起到部分中介作用。结论:强迫运动是进食障碍症状的重要风险因子,可通过依恋关系的中介作用影响进食障碍症状,依恋关系对强迫运动与进食障碍症状之间关系的中介效应具有性别差异。     

Fonagy and Freud. Psychological versus psychic reality

Peter Fonagy and Mary Target present their Playing with reality theory as a developmental theory centred on the concept of psychic reality. This paper compares Fonagy and Target's use of the concept of psychic reality with Freud's original concept. It is argued that the concept of psychic reality has been redefined from delineating a psychic reality stemming from the unconscious to denoting a kind of conscious or preconscious psychological reality characterized by an experience of equality between the internal and the external worlds. The theoretical discussion is illustrated by being applied to eating disorder pathology, which by Fonagy and colleagues is described as associated with thought processes characterized by psychic reality.     

Next Steps in Validation

No abstract available for this article.     

Theoretical underpinnings of a need-supportive intervention to address sustained healthy lifestyle changes in overweight and obese adolescents

ObjectivesRecent figures indicate that nearly a quarter of Australian adolescents are overweight or obese. Despite the well-established role of physical activity and healthy eating in reducing prevalence of obesity, there remains a lack of effective interventions that promote sustained behavior engagement. This paper aims to describe the theory-based integration and implementation of self-determination theory and goal setting theory in a family-based lifestyle intervention. Although these theories have been shown to independently predict motivation for behavior, a limited number of studies have described behavior-change techniques at a level to allow for effective evaluation and replication, and no studies have combined the theories in a healthy lifestyle behavior intervention.MethodsBehavior change techniques and the associated change mediators are described in relation to need-supportive environments provided by instructors and extended to parents in the home environment. Methods for motivating and promoting sustained engagement in adolescent physical activity and healthy eating and parent behaviors to support these lifestyle changes are discussed within the context of need-satisfaction and goal setting.ConclusionsThis study will contribute to understanding processes for developing and implementing behavior-change techniques based on the integration of two theories of motivation. Future interventions aimed at promoting maintenance of physical activity and healthy eating behaviors in overweight and obese adolescents will benefit by being informed of which techniques are effective at enhancing motivation within the intervention context and home environment.     

The Moderating Effects of Mindfulness on Psychological Distress and Emotional Eating Behaviour

Current evidence and theory suggests that emotional eating resulting from attempts to manage psychological distress, such as anxiety, depression, and stress, is considered to be a major contributor to obesity. Mindfulness has been shown to be related to disordered eating behaviours. Employing a non‐clinical sample of 42 males and 115 females, the present study investigated the contribution of mindfulness as a potential moderator between psychological distress and engagement in emotional eating, while controlling for the effects of gender and general nutrition knowledge. Consistent with predictions, psychological distress was positively associated with engagement in emotional eating, while mindfulness was found to share an inverse relationship. Moreover, after controlling for gender and general nutrition knowledge, the interaction between psychological distress and mindfulness was found to significantly predict the tendency to engage in emotional eating over and above the individual effects of these variables. The findings from the current study add to the current literature supporting the use of mindfulness‐based interventions for treatment of emotional eating practices in individuals experiencing anxiety, stress, and lower levels of depression.     

The Effects of an Anti-Nuclear War Film on Attitudes toward Nuclear Issues

This study tested the effects of an anti-nuclear war film on students' attitudes toward nuclear issues. Twenty-six male and female Canadian undergraduates were shown the film “If You Love This Planet”; another 26 were shown a neutral film. Students shown the anti-nuclear war film showed more support for activism and protest against nuclear war. The study provided evidence that a film can influence activist attitudes toward nuclear issues and that such attitudes are based more on self-concern than on altruistic concern about one's country. The study also found that males tended to be more optimistic than females about the future of the human race and more willing than females to sacrifice themselves for their country.