An investigation into the psychometric properties of the CORE‐OM in patients with eating disorders

Aim: The current study aimed to explore the psychometric properties of the CORE‐OM (Clinical Outcomes in Routine Evaluation – Outcome Measure) when used in an eating disorder sample. Method: The CORE‐OM was administered at assessment to 360 individuals referred to an eating disorders service. Principal component analysis was conducted to look at the psychometric structure of the CORE‐OM, and psychometric properties were investigated using analyses of reliability and validity. Results: Analyses of the psychometric structure suggested a three‐component solution reflecting negatively worded, positively worded and risk items. The CORE‐OM showed good acceptability, acceptable internal and test‐retest reliabilities, as well as good convergent and known groups validity. Conclusions: The results of the current study support the CORE‐OM as a reliable and valid measure for assessing psychological distress in eating disorders.     

Speed of Eating as a Determinant of the Bulimic Desire to Vomit

ABSTRACT

A single-case controlled study found that a bulimic's desire to vomit was virtually eliminated by slowed eating, but not by rapid eating. The present study attempted to determine whether this same relation was exhibited by a larger number (N = 6) of bulimics who were instructed to eat at a fast or a slow rate in a between-subjects reversal design. For all 6 participants, the urge to vomit was found to be greater during fast versus slow eating after comparable amounts of food intake. Clinically, these results suggest that eating slowly might be incorporated into treatment for bulimic vomiting.     

An investigation of the psychometric properties of the Eating Disorder Symptom Impact Scale within an Australian sample

Caring for patients with an eating disorder (ED) is associated with a high level of burden and psychological distress. Currently, the Eating Disorder Symptom Impact Scale (EDSIS) is the only scale that measures the specific impact of caring for a patient with an ED. The initial development study within a British sample of carers indicated that the EDSIS has a four‐factor structure. The aim of the current study was to confirm the factor structure of the EDSIS within an Australian sample of carers. One hundred and fifty‐four carers completed the EDSIS. In contrast to the initial study, a six‐factor structure was derived explaining 69.66% of the variance: guilt, social isolation, confrontational behaviours, binge–purge difficulties, mealtime difficulties, and illness awareness. Reliability was acceptable (Cronbach's alpha range 0.69–0.88). Five of the six factors were moderately correlated with the General Health Questionnaire‐12 (r range = 0.24–0.51). A six‐factor solution may be a valid alternative for the EDSIS.     

I Working with dissociative dynamics and the longing for excess in binge eating disorders

In this paper the author describes her work with a woman who, in her mid 20s, sought analysis for her non‐vomiting binge eating disorder. The paper explores how two aspects of Jung's view of the psyche as healthily dissociable were used to think about the potential for change contained within the explosive, aggressive energies in this patient's bingeing. The resultant approach takes the patient's splitting defences, dissociations and self‐destructive behaviour as a point of access to her unconscious. Seen in this way, these behaviours contain the seeds of recovery and are the starting point for analysis rather than defences against it. The paper also brings a number of Jungian and post‐Jungian ideas into conversation with aspects of contemporary thinking about subjectivity, identity and the longing for excess developed by Leo Bersani and Judith Butler.     

Self-help for binge eating disorder in primary care: A randomized controlled trial with ethnically and racially diverse obese patients

Objective

The objective was to examine the effectiveness of a self-help treatment as a first line primary care intervention for binge eating disorder (BED) in obese patients. This study compared the effectiveness of a usual care plus self-help version of cognitive behavioral therapy (shCBT) to usual care (UC) only in ethnically/racially diverse obese patients with BED in primary care settings in an urban center.

Method

48 obese patients with BED were randomly assigned to either shCBT (N = 24) or UC (N = 24) for four months. Independent assessments were performed monthly throughout treatment and at post-treatment.

Results

Binge-eating remission rates did not differ significantly between shCBT (25%) and UC (8.3%) at post-treatment. Mixed models of binge eating frequency determined using the Eating Disorder Examination (EDE) revealed significant decreases for both conditions but that shCBT and UC did not differ. Mixed models of binge eating frequency from repeated monthly EDE-questionnaire assessments revealed a significant treatment-by-time interaction indicating that shCBT had significant reductions whereas UC did not during the four-month treatments. Mixed models revealed no differences between groups on associated eating disorder psychopathology or depression. No weight loss was observed in either condition.

Conclusions

Our findings suggest that pure self-help CBT did not show effectiveness relative to usual care for treating BED in obese patients in primary care. Thus, self-help CBT may not have utility as a front-line intervention for BED for obese patients in primary care and future studies should test guided-self-help methods for delivering CBT in primary care generalist settings.     

A randomized wait-list controlled pilot study of dialectical behaviour therapy guided self-help for binge eating disorder

This study examined the efficacy of guided self-help based on dialectical behaviour therapy (DBTgsh) for binge eating disorder (BED). Individuals (88.3% female; mean 42.8 years) were randomized to DBTgsh (n = 30) or wait-list (WL; n = 30). DBTgsh participants received an orientation, DBT manual, and six 20-min support calls over 13 weeks. All participants were assessed pre- and post-treatment using interview and self-report; also, DBTgsh participants were re-assessed six months post-treatment. At treatment end, DBTgsh participants reported significantly fewer past-month binge eating episodes than WL participants (6.0 versus 14.4) and significantly greater rates of abstinence from binge eating (40.0% versus 3.3%). At six-month follow-up, DBTgsh participants reported significantly improved quality of life and reduced ED psychopathology compared to baseline scores. In addition, most improvements in the DBTgsh group were maintained, although binge eating abstinence rates decreased to 30%. These preliminary positive findings indicate that DBTgsh may offer an effective, low-intensity treatment option for BED.     

Amplitude Scaling Compensates for Serial Delays in Correcting Eye and Arm Movements

Spatial and metrical parameters of the eye and arm movements made by human subjects (N = 7) in response to visual targets that were stepped unexpectedly either once (single step) or twice (double step) were studied. For the double-step, the displacement of a visual target was decreased or increased in amplitude at intervals before and during a movement. Provided the second target step occurred more than 100 ms before the onset of movement, the amplitude of the subjects' first response was altered in the direction of the new target location. But this amplitude scaling was not always sufficient to reach the new target location, and a second corrective response was required. The latency in producing this second response was greatly increased above reaction time latencies of movements to single-step targets, especially when the target change occurred 100 ms or more before movement onset. These findings suggest that even though serial processing limitations delay the production of a second corrective response, continuous parallel processing of visual information enables the amplitude of the first response to be altered with minimal delay. This enables some degree of real-time continuous control by the visuomotor control system.     

Why does asking questions change health behaviours? The mediating role of attitude accessibility

Objective: The question-behaviour effect (QBE) refers to the finding that measuring behavioural intentions increases performance of the relevant behaviour. This effect has been used to change health behaviours. The present research asks why the QBE occurs and evaluates one possible mediator – attitude accessibility.

Design: University staff and students (N = 151) were randomly assigned to an intention measurement condition where they reported their intentions to eat healthy foods, or to one of two control conditions.

Main outcome measures: Participants completed a response latency measure of attitude accessibility, before healthy eating behaviour was assessed unobtrusively using an objective measure of snacking.

Results: Intention measurement participants exhibited more accessible attitudes towards healthy foods, and were more likely to choose a healthy snack, relative to control participants. Furthermore, attitude accessibility mediated the relationship between intention measurement and behaviour.

Conclusion: This research demonstrates that increased attitude accessibility may explain the QBE, extending the findings of previous research to the domain of health behaviour.     

Effects Of Negative Mood Induction On The Body Image Of Restrained Eaters

Abstract

Twenty restrained eaters (REs) and 20 unrestrained eaters (UREs) were studied via a distorting video image technique under three conditions: (1) baseline; (2) induction of negative mood (NM), (3) induction of positive mood (PM). Under each condition they were asked: (a) to estimate the actual width of their own body; (b) to focus attention on their bodily sensations and indicate how wide their body sensed and (c) to estimate the width of a water bottle. In addition, subjects answered a body shape questionnaire (BSQ). Main effects were found for the factors Group (REs gave higher estimates). Mood (estimates were higher after induction of negative mood), and Instruction (estimates were higher for sensed width of body). There were significant interaction effects for Group x Mood (estimations of REs were higher after induction of negative mood) and for Group x Mood x Instruction. Dissatisfaction with body shape (BSQ) was significantly correlated with the estimations of sensed body width after induction of negative mood.     

Religious Coping,Body Dissatisfaction,and Bulimic Symptomatology

The authors explored the association among body dissatisfaction, religious coping, and bulimic symptomatology. The results suggest that spiritual discontent religious coping was detrimental for the college female participants (N= 398) when considered in relationship to bulimic symptomatology. Implications of the findings for theory refinement, future research, and clinical practice are discussed.