The self and eating disorders

In our review, we focus on self-related constructs in the context of eating disorders with four aims. First, we examine a variety of self-related constructs that have been theoretically and empirically linked to the development and course of eating disorders. In addition to the more well-researched constructs of self-esteem and self-efficacy, we also report on findings related to selflessness, contingent self-worth, self-objectification, ego-syntonicity, self-concept clarity, self-compassion, social comparison, self-oriented perfectionism/self-criticism, and narcissism. Second, we discuss self-related constructs that may be especially relevant to comorbidities common among those with eating disorders. Third, we review intervention and prevention programs where self-related constructs play a prominent role. Lastly, we share future research directions regarding self-related constructs and eating disorders that we believe will advance a deeper understanding of the role of the self in the eating disorders.     

Postnatal trajectories of maternal depressive symptoms: Postpartum antecedents and differences in toddler adjustment

Infants are uniquely vulnerable to maternal depression's noxious effects, but few longitudinal studies have tried to identify discrete postnatal trajectories of maternal depressive symptoms (MDS) beginning in infancy. This study extends evidence of heterogeneous change in postnatal MDS by examining their cross-contextual antecedents in infancy and their consequences for children's early behavior problems and language skills in late toddlerhood. A community sample of mother–child dyads (N = 235, 72% Caucasian) was assessed when children were 7, 15, and 33 months old. Mothers reported their socioeconomic status (SES), social support, marital relationship quality, family dysfunction, parenting stress, and infants’ functional regulatory problems at 7 months postpartum, and children's internalizing and externalizing symptoms at 33 months. Children completed a receptive vocabulary assessment at 33 months in the lab. Latent class growth analysis identified three postnatal MDS trajectory classes that fit the data best: low-decreasing, moderate, and increasing. Psychosocial measures at seven months postpartum primarily predicted membership to these postnatal trajectory classes, which subsequently differed in children's internalizing, externalizing, and receptive vocabulary in late toddlerhood, controlling for family SES and functional regulatory problems in infancy. We discuss salient antecedents and consequences of postnatal depression for mothers and their offspring.     

Differential association between food craving,food addiction and eating-related characteristics in persons at risk for eating disorders

IntroductionFood craving is a key feature of eating disorders, but its association with medical and psychological outcome might depend on the type of eating disorder.ObjectivesThis study investigated the factors associated with food craving in individuals at risk for DSM-5 eating disorder.MethodSeventy-six women were recruited from a non-clinical population (n = 372) based on their positive screening (EDDS, QEWP-R) for binge eating disorder (BED; n = 29), anorexia nervosa (AN; n = 28) or bulimia nervosa (BN; n = 19). They completed self-administered questionnaires assessing food craving (FCQ- T-r), Body Mass Index (BMI), eating behaviour (DEBQ), food addiction (YFAS 2.0), and anxiety and depressive symptoms (HADS).ResultsIndividuals at risk for BED or BN had higher food craving than those at risk for AN. Food craving was associated with BMI only in the BED group. Food craving was positively correlated with external eating in all groups, and with emotional eating in the AN and BED groups and correlated with anxiety only in BN. Food addiction prevalence was higher in the BN group than in the AN or BED groups (respectively 94.7%, 46.4% and 65.5%; p < 0.01). In this non-clinical population, we demonstrated that food craving was differentially associated with BMI and eating-related characteristics according to the type of eating disorder.ConclusionThis suggests that food craving is a transdiagnostic dimension that should be differentially targeted depending on the type of eating disorder; future studies should test this hypothesis in clinical populations.     

关系精神分析的心身障碍治疗观

关系精神分析的临床治疗范围已涉及心身障碍患者。不同于古典精神分析的心身二元论, 关系精神分析的心身观认为心理与身体是一个统一体, 两者相互作用并紧密联系。关系精神分析师阿隆认为, 心身障碍患者的主要特征是分离现象, 分离现象有三种层次。关系精神分析以关系性的视角看待心身障碍, 认为其病因在于创伤性事件与养育失败, 其病理表现为身心不协调, 情感淡漠及躯体症状等。分析治疗的目标在于通过在共同参与的分析情境中, 建立分析师与患者安全与信任的关系, 提高患者自我反思能力、情感调节能力, 从而修复心身关系。     

A comparison of methods for assessing preference for social interactions

Researchers have evaluated a variety of methods for assessing preference for social interactions, and generally have found that such assessments accurately identify differentially reinforcing, preferred interactions. However, few researchers have compared methods for assessing preference for social interactions, and none have done so with participants across different skill levels. The current study compared the stability and validity of hierarchies produced by social interaction preference assessments (SIPA) and picture-based multiple stimulus without replacement preference assessments (MSWO) with 8 individuals diagnosed with autism spectrum disorder (ASD). The MSWO most often produced valid hierarchies for participants who could match, identify, and tact pictures of social interactions and that the SIPA most often produced valid hierarchies for participants who could not identify or tact pictures of social interactions. A vocal paired-stimulus preference assessment (PSPA) was also conducted with a subset of participants who communicated vocally, and it produced valid hierarchies. Considerations and recommendations for selecting a method of assessing preference for social interactions are discussed.     

Unfolding Relations among Mindful Parenting,Recurrent Conflict,and Adolescents’ Externalizing and Internalizing Problems

The current study examined unfolding relations among mothers’ mindful parenting, parent–adolescent recurrent conflict, and adolescents’ externalizing and internalizing problems. In a community sample of 117 families (31% black, Asian, American Indian, or Latino), parents and adolescents (52% female; average age = 12.13 years) were followed over 15 months. Parents answered questions about mindful parenting and recurrent conflict, and adolescents reported on their own externalizing and internalizing problems. Path analyses indicated that higher levels of mindful parenting were significantly related to lower levels of recurrent conflict 2–3 months later, controlling for previous levels of recurrent conflict. Moreover, lower levels of recurrent conflict were significantly related to lower levels of externalizing problems and internalizing problems 1 year later, controlling for previous levels of those problems. Subgroup analyses indicated that relations were comparable across subgroups defined by adolescent gender, race, parent marital status, and family financial strain. The effects of mindful parenting were robust even after accounting for other indicators of positive and supportive parenting, namely inductive reasoning and warmth in the parent–adolescent relationship. These findings highlight the potential of mindful parenting to improve family interactions and adolescent adjustment.     

Behavioral Parent Training Engagement Among Young Children With Autism Spectrum Disorder

The purpose of the current study was to examine engagement with Behavioral Parent Training (BPT) for families of children with Autism Spectrum Disorder (ASD) and assess openness to novel delivery formats for BPT (e.g., telehealth, group). Participants were caregivers of 501 children with ASD (ages 2–6) enrolled in the SPARK (Simons Foundation Powering Autism Research for Knowledge) online national registry. The study assessed: (1) rates of child disruptive behavior diagnoses, (2) engagement and satisfaction with BPT, (3) parent and child factors (e.g., diagnostic history), and (4) openness to novel delivery formats. Almost 25% of young children with ASD in this sample had disruptive behavior problems rising to the level of a diagnosis of ADHD or ODD and thus would benefit from BPT. However, only one third of these families had actually been referred to BPT. Families indicated high level of interest in participating in BPT, with a particular interest in Parent Child Interaction Therapy (PCIT) as well as novel delivery formats such as telehealth and group. Specific components of the therapy and delivery formats were indicative of parent satisfaction (e.g. groups, longer treatment sessions, longer treatment length). Specific parent and child characteristics were predictive of openness to novel formats (e.g. parental depression, more severe behavioral challenges, lower verbal skills). Results underscore the need for increased referrals and access to BPT programs the ASD population. Both parent and child characteristics are important for determining appropriate delivery formats.