25
Bethesda, Maryland | September 19-21, 2013
POSTER SESSION 1 ABSTRACTS
T1
Do Therapist Attitudes Towards Family-Based Treatment Guide Their
Intended Practice?
Erin C. Accurso, Anna C. Ciao, Daniel Le Grange
The University of Chicago, Chicago, IL, USA
Family based treatment (FBT) is an efficacious treatment for adolescent
Anorexia Nervosa (AN) but used by few therapists in the community. This
study sought to describe therapist practices and how attitudes towards
FBT might impact future practice. Therapists (n=33, 90 expected) were
evaluated prior to a two-day FBT training on their use of treatment
techniques for adolescent AN, including techniques both consistent
with and inconsistent with FBT. Post-training, they completed a parallel
measure on their intended practice and their attitudes towards FBT.
Therapists reported frequent use of several techniques consistent
with FBT, including externalizing the disorder (93%), impressing upon
parents the immediacy of AN (86%), weighing patients (50%), and openly
discussing changes in weight (50%). Common “adjunctive” practices
included individual CBT (75%) and DBT (43%), and referring to a dietician
or meal plan (85%). Following training, therapists had positive attitudes
towards FBT’s treatment credibility (85%) but endorsed concerns about
its appropriateness and feasibility with respect to personal (73%), patient
(52%),
and organizational factors (58%). More positive attitudes towards
FBT predicted greater intent to use FBT strategies (β=.47, p=.007),
controlling for current strategy use (overall model: F
2,21
=18.81, p<.0001,
Adjusted R
2
=.61). Fostering positive attitudes towards FBT, including
overcoming organizational barriers, may be important in changing usual
care practice.
T2
Differential Item Functioning Between Men and Women on Common
Measures of Body Dissatisfaction
Drew A. Anderson, Erin E. Reilly, Lisa M. Anderson, Katherine E.
Schaumberg
University at Albany - State University of New York, Albany, NY, USA
Introduction
:
The majority of studies examining discontent with shape
have employed measures of body image designed with female samples.
The current investigation examines differential item functioning between
men and women on three commonly utilized body image measures.
Methods
:
Male and female university students completed the body
dissatisfaction subscales of the Eating Disorder Inventory (EDI-BD; N
= 578) and the Eating Disorder Examination Questionnaire (EDE-Q-
BD; N = 1128), and the Body Shape Questionnaire (BSQ; N = 598). To
evaluate differential item functioning in each measure, we developed
three predictors of an item score, and calculated the significance of these
predictors utilizing ordinal logistic regression. Predictors included the total
score on each measure as an overall measure of body dissatisfaction,
gender, and the interaction between the overall measure and gender. An
item is identified as a DIF item if the latter two variables show a statistically
significant improvement beyond a model that includes only the global
score on each measure.
Results
:
While many items evidenced statistically
significant DIF, only one item from the BSQ evidenced clinically significant
DIF between men and women.
Conclusions
:
Overall, findings from this
investigation indicate that, while men and women differ on their average
level of body dissatisfaction as reported on these body image scales,
relatively low differential item functioning is apparent in these measures.
T3
Residents Knowledge and Attitudes Towards Patients with Eating
Disorders
Kristen E. Anderson, Catherine Glunz, Erin C. Accurso, Daniel Le Grange
University of Chicago Medicine, Chicago, IL, USA
Introduction:
Attitudes towards patients with eating disorders (EDs)
differs across medical professionals, but little is known about attitudes
are impacted by training and exposure to EDs.
Method:
Medical trainees
(
n=80, 64.5% participation) across Pediatrics (20%), OBGYN (7.5%),
Med/Peds (22.5%), Internal Medicine (2.5%) and Psychiatry (16%) were
surveyed. Trainees included residents (71%), interns (25%), and fellows
(4%).
Results:
The majority of residents (80%) had treated at least one
ED patient, but few (13%) had treated more than 5. Of those with any
ED experience, only 14% reported enjoying working with this population.
Both psychiatry residents (χ
2
=8.47, p=.014) and residents who had
treated at least one ED patient (χ
2
=6.35, p=.042) reported greater comfort
levels in treating EDs. In contrast, psychiatry residents were more likely
to believe that patients with Anorexia Nervosa can do a lot to control
their symptoms (χ
2
=7.93, p=.019), whereas those with ED experience
disagreed with this statement (χ
2
=6.43, p=.040). Interestingly, residents
with more ED training (≥4 CMEs, 34%) were more likely to believe that
patients with Bulimia Nervosa are largely responsible for their disorder
(
χ
2
=8.12, p=.017).
Conclusion:
Resident physicians’ direct exposure to
ED patients is limited, with relatively little specialty training in working with
this population. Both direct ED experience and specialty training appear to
impact attitudes about EDs, but these effects are mixed.
T5
Effectiveness of School-Based Eating Disorders Screening
S. Bryn Austin
1,2
,
Davene Wright
3
,
Yushan Jiang
2
,
LeAnn Noh
2
,
Kendrin R
Sonneville
1
1
Boston Children’s Hospital, Boston, MA, USA,
2
Harvard School of Public
Health, Boston, MA, USA,
3
Seattle Children’s Hospital, Seattle, WA, USA
Introduction:
Some U.S. states are considering implementing school-
based eating disorder (ED) screening, but the impact of such screening
on early ED diagnosis and treatment duration is unknown.
Methods
:
We
used a decision-analytic model to simulate the effectiveness of an annual
school-based ED screening program compared to current practice of no
ED screening on reducing the duration of illness for ED. We modeled
the number of cases of anorexia nervosa, bulimia nervosa, and binge
eating disorder that would be identified and treated over a 10 year
horizon through screening versus current practice. We obtained model
inputs, including the sensitivity and specificity of screening instruments,
prevalence of ED, and rates of ED recovery from the best available
literature. We estimated the reach of the intervention using school
enrollment data from the National Center for Education Statistics. We
conducted uncertainty analyses on model inputs parameters.
Results:
We
estimated that over 10 years, 29.5 million 5
th
-12
th
graders in the U.S. would
each spend an average 3.5 fewer months with an ED through screening
compared to current practice due to early identification. The model was
sensitive to ED prevalence levels and recovery rates.
Conclusions:
Screening for ED in schools would be effective in reducing the duration of
illness for ED. Future studies are needed to assess the cost-effectiveness
of school-based ED screening in order to determine the value of an ED
screening policy.
T6
Concern for Appropriateness Mediates the Link Between Disordered
Eating and Hypnotizability
Rachel Bachner-Melman
1,2
,
Raz Levin
3,4
,
Pesach Lichtenberg
3,5
1
Social and Community Sciences, Ruppin Academic Center, Emek Hefer,
Israel,
2
Psychology, Hebrew University of Jerusalem, Jerusalem, Israel,
3
Herzog Memorial Hospital, Jerusalem, Israel,
4
Neurobiology, Hebrew
University, Jerusalem, Israel,
5
Medical School, Hebrew University of
Jerusalem, Jerusalem, Israel
Introduction
:
This study aimed to replicate a previously observed link
between disordered eating and hypnotizability, and offer a possible
explanation for it. We previously found Concern for Appropriateness
(
Lennox and Wolfe, 1984) to correlate with eating attitudes, and
hypothesized that this protective self-presentation style would influence
not only eating attitudes but also ‘appropriate’ behavior in the hypnotic
context. We therefore expected Concern for Appropriateness to mediate
the association between eating attitudes and hypnotizability.
Methods
:
50
participants (33 women, 17 men) between 15 and 30 years of age
completed the Eating Attitudes Test-26 (EAT-26) and the Concern for
Appropriateness Scale (CAS), and were administered the Stanford
Hypnotic Susceptibility Scale: Form C (SHSS:C).
Results
:
As expected,
EAT-26 scores correlated with SHSS:C scores (R=0.33, p=0.01), as did
CAS scores (R=0.43, p=0.001). Yet when both EAT-26 and CAS were
regressed simultaneously on SHSS:C scores, the CAS but
not
the EAT-26
remained significant. The Sobol Test of Mediation was significant (p=0.17).
Conclusions
:
Results provided support for our hypothesis; Concern for
Appropriateness was found to mediate the link between eating attitudes
and hypnotizability. Individuals with problematic eating attitudes may tend
to be more hypnotizable than those with normal eating attitudes at least
in part because they tend to be on the constant lookout for social cues to
guide their behavior.
T7
Patterns of Neural Activation in Women With Bulimia Nervosa During
General and Eating Response Inhibition: Preliminary Results from a
Novel Task
Laura A Berner
1
,
Hasan Ayaz
1
,
Rachel Marsh
2
,
Patricia A Shewokis
1
,
Meltem Izzetoglu
1
,
Samantha Winter
1
,
Alyssa Matteucci
1
,
Jennifer Nasser
1
,
Michael R Lowe
1
1
Drexel University, Philadelphia, PA, USA,
2
New York State Psychiatric
Institute and the Columbia University College of Physicians and Surgeons,
New York, NY, USA
Introduction.
Individuals with bulimia nervosa (BN) perform more
impulsively and activate lateral PFC less than control participants during
inhibitory control tasks. These findings may be related to the “loss of
control” over eating during binge episodes.
Methods
.
To directly assess
eating control, we developed a novel go/no-go (GNG) task that requires
inhibition of prepotent sipping and swallowing of a yogurt shake. To
POSTER SESSION 1 ABSTRACTS - THURSDAY
