46
EDRS 2013
course and treatment.
Methods
:
Infantile Anorexia
(
IA),
Feeding Disorder
Associated with Insults to the Gastrointestinal Tract
(
FDIGT), and
Sensory
Food Aversions
(
SFA) will be presented by exploring: mother-child
interactions; children’s emotional functioning; maternal psychological
status and eating attitudes. All dyads were videotaped during feeding;
mothers completed
EAT
-
40
,
SCL-90
,
CBCL/
1½-5.
Results
:
Significant
differences emerged among the FD subtypes in Anticipatory Distress and
Resistance to Food. Children with FDIGT and IA showed less optimal
mother-child interactions. Children with FDIGT showed higher scores in
Aggressive Behavior
.
Children with IA showed higher scores in
Anxiety/
Depression
.
Mothers of IA-group showed higher scores in:
Somatization,
Depression, Dysfunctional Eating.
Conclusions:
results highlight the
importance of early diagnosis and specific treatments for each of the
disorders.
F40
Improvements in Weight-Based Self-Esteem and Body Checking
Reliably Co-Occur for Bulimia Nervosa and EDNOS Patients with
Good Response to Day Hospital Treatment
Danielle E. MacDonald
1, 2
,
Traci L. McFarlane
2, 3
,
Kathryn Trottier
2, 3
,
Marion
P. Olmsted
2, 3
1
Ryerson University, Toronto, ON, Canada,
2
University Health Network,
Toronto, ON, Canada,
3
University of Toronto, Toronto, ON, Canada
1.
INTRODUCTION
:
Cognitive behavioral perspectives view body
checking as a behavioral manifestation of weight-based self-esteem
(
WBSE). This study investigated this by examining whether meaningful
changes in WBSE reliably accompanied meaningful changes in body
checking. 2.
METHODS
: 129
patients with 8+ bingeing or vomiting
episodes in the month prior to treatment and BMI >18.5 exhibited good
response to day hospital treatment and were eligible for the study (78.3%
BN, 21.7% EDNOS). Good response was defined as a maximum of 2
episodes in the last 4 weeks of treatment. Meaningful change was defined
as
both
statistically reliable and clinically significant change (Jacobson &
Truax, 1991). 3.
RESULTS
:
Chi square analyses indicated that meaningful
improvements in WBSE and body checking reliably co-occurred for good
responders to bingeing and vomiting interruption, when WBSE was
defined as follows: Weight Influenced Self-Esteem Questionnaire, χ²(1) =
26.9,
p
<.001,
V
2
= .24; EDE-Q Weight Concerns, χ²(1) = 37.0,
p
<.001,
V
2
= .29; and EDE-Q Shape Concerns, χ²(1) = 29.5,
p
<.001,
V
2
= .23. 4.
CONCLUSIONS
:
In patients who show a positive treatment response,
those who meaningfully improve body checking are also more likely to
meaningfully improve WBSE. The absence of meaningful change on both
variables also occurred together. These findings support body checking as
a manifestation of WBSE by showing that improvements on both variables
(
and lack thereof) are likely to co-occur.
F41
Clinical Outcomes of a Day Hospital Treatment Program for Eating
Disorders
Enrica Marzola, Giovanni Abbate-Daga, Annalisa Brustolin, Stefania
Campisi, Sara Buzzichelli, Carlotta De-Bacco, Secondo Fassino
University of Turin, Eating Disorders Center, Department of
Neurosciences, Turin, Italy
Introduction
.
Anorexia Nervosa (AN) and Bulimia Nervosa (BN) are
deadly disorders of unknown etiology and unpredictable outcome.
They are often chronic and disabling also because of the current dearth
of effective treatments.
Methods
. 66
female adults affected by AN
and BN were recruited at the Day Hospital (DH) for Eating Disorders
(
EDs) of the University of Turin, Italy. The DH has a specific emotion-
focused approach. Using a longitudinal design, we assessed patients at
admission (t0), discharge (t6) and at both six (t12) and 24-month (t30)
follow-up. In addition to clinical data we used questionnaires: Eating
Disorders Inventory-2, Temperament and Character Inventory, Body
Shape Questionnaire, Beck Depression Inventory, Rosemberg Self-
Esteem Scale; and interviews: Brief Social Phobia Scale and Morgan-
Russell Outcome Assessment Schedule. We also performed the Global
Assessment of Functioning and a clinical evaluation of the outcomes.
Results
.
In spite of patients’ long duration of illness (7.09±4.99 years)
and non-responsiveness to previous treatments (59.1%), a large part of
the sample improved (75.5%) with some showing remission (10.2%) at
discharge. Body Mass Index and most scales significantly improved at t6.
At t12 and t30 these results were considerably maintained.
Conclusions
.
The DH treatment showed positive results despite patients’ clinical
severity. Further studies are warranted to confirm these findings and shed
light on effective interventions for EDs.
F42
Examining Social and Physical Self-Knowledge Using fMRI in
Anorexia and Bulimia
Carrie J McAdams
1
,
Daniel C Krawczyk
1,2
1
University of Texas at Southwestern Medical Center, Dallas, TX, USA,
2
University of Texas at Dallas, Dallas, TX, USA
Eating disorders include bulimia nervosa (BN), an illness characterized by
both binging and purging eating behaviors with maintenance of a normal
body weight, and anorexia nervosa (AN), an illness characterized by
restrictive eating behaviors and a low body weight. For both illnesses, self-
evaluation that is unduly dependent upon body shape and weight is part of
the diagnostic criteria. We examined self-knowledge using self-evaluation
tasks in 53 adult women (18 AN, 17 BN, and 18 control (CN)). The Social
Appraisal task asked subjects to evaluate the validity of personalized
statements with social adjectives. The Physical Appraisal task presented
similar statements with physical phrases. Recently, using whole-brain
voxel-wide comparisons of the AN and CN groups, we reported regions
in the precuneus (PreC), dorsal anterior cingulate (dACC) and the middle
cingulate (Cing) with significant differences. Here, we report the neural
activations in these regions in subjects with BN. In all regions, the BN
percent signal change fell between activation levels observed in the CN
and AN subjects. Statistically, the BN responses were not significantly
different from the AN responses but were different from the CN responses
in two of the three regions, the PreC and dACC. These data suggest that
neural activity related to processing self-knowledge are very similar in AN
and BN, with stronger similarities observed in the social self-knowledge
ROIs than the physical self-knowledge ROI.
F43
Effects of Hunger and Satiety on Reward-Related Affect in Anorexia
Nervosa
Gabriella Milos
1
,
Sena Kuyumcu
1
,
Oliver Goetze
1
,
Christoph Mueller-
Pfeiffer
1
,
Volker Baur
1
,
Marcus Fried
1
,
Andreas Steingötter
2
,
Chantal
Martin-Soelch
3
1
University Hospital, Zurich, Switzerland,
2
Science & Tecnology University,
Zurich, Switzerland,
3
University, Frieburg, Switzerland
Introduction
:
Altered reward processing has been reported in anorexia
nervosa (AN) in previous studies, showing reduced striatal activation to
natural as well as monetary rewards. Here we investigated the effect of
hunger and satiety on mood related to monetary rewards in AN patients.
Methods
:
Ten participants with current AN and 11 healthy subjects
without psychiatric disorders performed a validated gambling task (wheel
of fortune) with empty stomach (T1, hunger) and after having eaten
a standard meal (T2, satiety). To assess mood, positive and negative
affective schedule (PANAS) questionnaire was used. Data analysis was
done with ANOVA.
Results
:
Both groups were satiated after eating. Regarding hunger
feelings, ANOVA showed a trending difference between AN and healthy
subjects before eating: Healthy subjects’ hunger ratings did not change
after reward, whereas in AN, hunger ratings decreased. Reward had a
significant effect on positive affect both before and after eating in healthy
subjects, whereas in AN this effect was only seen after (and not before)
eating.
Conclusions
:
Our study indicates altered hunger feelings and
mood in AN following monetary reward. This will be substantiated by
investigating a larger sample of subjects.
F44
Comparison Of DSM-IV Diagnostic Criteria Versus the Broad
Categories for the Diagnosis of Eating Disorders Scheme in a
Japanese Sample
Yoshikatsu Nakai
1
,
Kazuko Nin
2
,
Stephen Wonderlich
3
1
Kyoto Institute of Health Sciences, Kyoto, Japan,
2
School of Health
Sciences, Faculty of Medicine, Kyoto University, Kyoto, Japan,
3
University
of North Dakota, School of Medicine and Health Sciences, Fargo, ND,
USA
Introduction
:
The purpose of this study was to compare DSM-IV
diagnostic criteria and the Broad Categories for the Diagnosis of Eating
Disorders (BCD-ED) scheme in terms of the number of cases of eating
disorder not otherwise specified (EDNOS) and to test which diagnostic
tool better captures the variance of psychiatric symptoms in a Japanese
sample.
Methods
:
One thousand and twenty-nine women with an eating
disorder (ED) participated in this study. Assessment methods included
structured clinical interviews and administration of the Eating Attitudes
Test and the Eating Disorder Inventory.
Results
:
The BCD-ED scheme
dramatically decreased the proportion of DSM-IV EDNOS from 45.1% to
1.5%.
However, the categorization of patients with the BCD-ED scheme
was less able to capture variance in psychopathology scales than the
DSM-IV, suggesting that the BCD-ED scheme may differentiate ED groups
less effectively than the DSM-IV.
Conclusion
:
These results suggest that
the BCD-ED scheme may have the potential to eliminate the use of DSM-
IV EDNOS, but it may have problems capturing the variance of psychiatric
symptoms.
F45
Refeeding Malnourished Adolescents with Anorexia Nervosa:
Randomised Controlled Trial
Graeme O’connor
1
,
Dasha Nicholls
1
,
Atul Singhal
2
1
Great Ormond Street Hospital, London, United Kingdom,
2
Institute Of
Child Health, London, United Kingdom
Background
This study aimed to monitor the biochemical and
cardiovascular response whilst refeeding malnourished adolescent
inpatients with AN.
Methods
Adolescents [n=36; mean (SD): 13.6yrs old
POSTER SESSION 2 ABSTRACTS
