Assessment and Diagnosis of Eating Disorders: A Guide for Professional Counselors

Despite the prevalence of and risk associated with disordered eating, there are few guidelines for counselors on how to conduct an eating disorder assessment. Given the importance of the clinical interview, the purpose of this article is to provide recommendations for the assessment and diagnosis of eating disorders that (a) specifically focus on assessment in the context of a clinical interview and (b) can be used by counselors whether or not they specialize in eating disorder treatment.     

Disordered Eating in Women of Color: Some Counseling Considerations

There is little attention devoted to studying eating disorder symptoms in racially and ethnically diverse groups despite the fact that the prevalence rates among women of color for eating disorder symptoms are similar to those of European American women. This article reviews research related to eating disorders in women of color, including a discussion of sociocultural factors that could influence the manifestation of eating disorders in women of color. Considerations for counseling practice and research are provided.     

Is there evidence for the use of art therapy in treatment of psychosomatic disorders,eating disorders and crisis? A comparative study of two different systems for evaluation

A comparative study of two different systems for evaluation. Scandinavian Journal of Psychology 53, 47-53. As with any type of treatment the requirement for evidence based practice (EBP) has also affected art therapy (AT) when used as an intervention. This review evaluates the available evidence for using AT for psychosomatic disorders, eating disorders and crisis. The search in Cochrane, Best Practice, AMED, CINAHL, PION, PsycINFO and PubMed from 1987 until now resulted in a huge number of articles but only 32 articles met our criteria for evaluations. The articles were assessed with two evaluation systems, the GRADE system used by the Swedish Council on Health Technology Assessment (SBU) and the US Preventive Services Task Force (USPSTF/Task Force). When comparing the results we found that the GRADE evaluation system rejected the quality in 84% of the 32 studies and the USPSTF/Task Force 41% of these studies. An evidence base for AT was found only according to the criteria of USPSTF/Task Force. Hence, the evidence concept is not explicit, which means that effective treatments run a risk of not being implemented in health care. We suggest a broader view of what constitutes evidence in order to make it possible to include different types of research designs and methods.     

Mental health problems and post-migration stress among multi-traumatized refugees attending outpatient clinics upon resettlement to Norway

Refugees have often been exposed to multiple traumas making them prone to mental health problems later. The aim of this study is to describe the prevalence and symptom load of psychiatric disorders in refugees admitted to psychiatric outpatient clinics and to investigate the relationship between multiple exposure to traumatic events, the severity of traumatic symptoms and post-migration stressors. A clinical sample of 61 refugee outpatients from psychiatric clinics in Southern Norway was cross-sectionally examined using three structured clinical interviews (SCID-PTSD, SIDES and MINI) and self-report psychometric instruments (HSCL-25, IES-R). Post-traumatic Stress Disorder (PTSD) was diagnosed in 82% of the patients, while Disorders of Extreme Stress Not Otherwise Specified (DESNOS) was present in 16% of them. Comorbidity was considerable; 64% of the patients had both PTSD and major depression disorder (MDD) and 80% of those who had PTSD had three or more additional diagnoses. Multi-traumatized refugees in outpatient clinics have high prevalence of PTSD, DESNOS, comorbid depression and anxiety disorders. A more severe symptomatology was found in patients diagnosed with both PTSD and DESNOS, than in those diagnosed with only PTSD. Higher rates of unemployment, weak social network and weak social integration were also prevalent in these outpatients, and related to increased psychiatric comorbidity and severity of symptoms. Further research may clarify the existence of a cumulative relationship between pre-resettlement traumas and post-resettlement stressors in the mental health of refugees, which in turn may help to improve therapeutic interventions.     

Personality and Substance Use in Midlife: Conscientiousness as a Moderator and the Effects of Trait Change

Personality traits predict substance use in adolescence, but less is known about prospective substance use in middle age and beyond. Moreover, there is growing interest in how personality change and the multiplicative effects among personality traits relate to substance use. Participants included approximately 4000 adults aged 25-74 who participated in two waves of the Midlife in the US (MIDUS) study. Higher levels of neuroticism, extraversion, openness, and lower levels of conscientiousness and agreeableness predicted longitudinal substance use. Increases in neuroticism and openness predicted increased substance use while increases in conscientiousness and agreeableness predicted decreased substance use. Higher levels of conscientiousness moderated two of the other trait main effects. Personality, trait change, and interactions among traits reliably forecasted 10-year substance-use behaviors.     

Co-localisation of abnormal brain structure and function in specific language impairment

We assessed the relationship between brain structure and function in 10 individuals with specific language impairment (SLI), compared to six unaffected siblings, and 16 unrelated control participants with typical language. Voxel-based morphometry indicated that grey matter in the SLI group, relative to controls, was increased in the left inferior frontal cortex and decreased in the right caudate nucleus and superior temporal cortex bilaterally. The unaffected siblings also showed reduced grey matter in the caudate nucleus relative to controls. In an auditory covert naming task, the SLI group showed reduced activation in the left inferior frontal cortex, right putamen, and in the superior temporal cortex bilaterally. Despite spatially coincident structural and functional abnormalities in frontal and temporal areas, the relationships between structure and function in these regions were different. These findings suggest multiple structural and functional abnormalities in SLI that are differently associated with receptive and expressive language processing.     

Dispositional pessimism but not optimism is related to sickness absence caused by musculoskeletal symptoms

Musculoskeletal disorders account for a higher proportion of sickness absence from work in the European Union than any other health condition. The present study examined the associations between work environment, dispositional optimism/pessimism and medically certified sickness absence caused by musculoskeletal complaints in a sample of employees from the Norwegian Armed Forces (N = 1190, 77.5% men). Dispositional pessimism, but not optimism, predicted the amount of absence also when taking into account the effects of age and the work environment. Overall, our results support previous studies suggesting that pessimism is a more salient predictor of physical health than optimism. Our results also suggest that it may be beneficial for employers to combine medical treatment of musculoskeletal symptoms with psychological treatment targeting pessimistic outcome expectancies in order to reduce the amount of sickness absence.     

Mood-congruent thoughts and personality disorder pathology

The primary aim of this research was to investigate associations that depression severity and trait anxiety have with reactions to specific, identifiable thoughts experienced by persons with varying levels of personality disorder (PD) pathology as they went about their day-to-day lives. Ninety-eight psychotropic medication-free persons participated in an experience sampling assessment procedure over four consecutive days, during which participants recorded specific thoughts experienced moments before a page signal was received and corresponding ratings of thought discomfort. Thought discomfort, regarded as an emotional reaction to thoughts or their evaluation, was moderately associated with several forms of PD pathology, particularly Cluster C pathology. Once depression severity and trait anxiety were controlled, however, associations between PD pathology and thought discomfort were eliminated. Findings from this research generally support the mood-congruence of negatively valenced thoughts in relation to PD pathology.     

Assessing interpersonal functioning: Views from within and without

In order to better integrate research on personality pathology, interpersonal problems, and social skills, we applied the traditional methods of these three research strands (questionnaires, interviews, and interpersonal role-plays) to the same sample. Participants who attributed higher levels of interpersonal problems to themselves in general were also more critical of their own role-play performances, but these impressions were not mirrored by observer-ratings. Self-observer agreement in judging overall role-play performance was essentially zero. Interviewer-ratings of personality pathology had incremental validity over self-ratings in predicting observer-rated role-play performance. Self-reports of interpersonal functioning leave relevant behavioral variance untapped and thus should be complemented by other sources of information.