50
EDRS 2013
Only 3-20% of those with eating disorders receive treatment, in part
because extant treatments are extremely intensive, suggesting that a brief
front-line treatment for the full spectrum of eating disorders that could be
easily disseminated would have enormous public health utility.
Methods
: 88
young women with DSM-5 eating disorders were randomized
to an 8-session dissonance group involving verbal, written, and behavioral
activities in which participants critique pursuit of the thin ideal and eating
disordered behaviors or a usual care control condition, completing pre
and post blinded diagnostic interviews.
Results
:
Treatment produced
significantly stronger reductions in eating disorder features and symptoms
(
M d = .65) than the control condition in which 54% received usual care.
Conclusions
:
These effects compare favorably to the effects (M d = .98)
of a more costly individual enhanced CBT for clients with BN and BED
spectrum eating disorders, implying that this inexpensive front-line treatment
for the full spectrum of DSM-5 eating disorders has the potential for broad
dissemination and public health benefit.
F63
An Investigation of the Etiology of Thin-Ideal Internalization During
Puberty
Jessica L. Suisman
1
,
J. Kevin Thompson
2
,
Pamela K. Keel
3
,
S. Alexandra
Burt
1
,
Michael Neale
4
,
Steven Boker
5
,
Cheryl Sisk
1, 6
,
Kelly L. Klump
1
1
Department of Psychology, Michigan State University, East Lansing, MI,
USA,
2
Department of Psychology, University of South Florida, Tampa, FL,
USA,
3
Department of Psychology, Florida State University, Tallahassee,
FL, USA,
4
Department of Psychiatry and Human Genetics, Virginia
Commonwealth University, Richmond, VA, USA,
5
Department of Psychology,
University of Virginia, Charlottesville, VA, USA,
6
Neuroscience Program,
Michigan State University, East Lansing, MI, USA
Introduction
.
Mean level increases in thin-ideal internalization have
been observed across pubertal development. No study has examined
if these increases are associated with shifts in etiologic (i.e., genetic/
environmental) risk; although studies of disordered eating (DE) have shown
increased genetic, and decreased shared environmental, influences across
puberty. This study is the first to examine if the same pattern emerges for
thin-ideal internalization.
Methods.
Participants were 940 female twins
(
ages 8-25 years) from the Michigan State University Twin Registry. Thin-
ideal internalization and pubertal development were assessed with the
Sociocultural Attitudes toward Appearance Questionnaire and the Pubertal
Development Scale.
Results.
Twin moderation models suggest that pubertal
development significantly moderates genetic influences on thin-ideal
internalization. Specifically, the heritability of thin-ideal internalization was
higher in pubertal (41%) versus pre-pubertal (1%) twins. However, effects
appeared to be less robust than those found for DE and varied with different
measures of pubertal status and thin-ideal internalization.
Conclusions.
Findings suggest that, like DE, puberty activates genetic risk for thin-ideal
internalization. Future work should investigate genetic/biological systems
that influence thin-ideal internalization and if these systems are the same as
those that influence DE.
F64
Influence of Autonomous Motivation on Treatment Outcome for
Inpatients with Anorexia Nervosa
Lea Thaler
1,2
,
Ashley Wanamaker
3
,
Samantha Wilson
1
,
Mimi Israel
1,2
,
Howard Steiger
1,2
1
Eating Disorders Program,Douglas University Institute, Montreal, QC,
Canada,
2
Psychiatry Department, McGill University, Montreal, QC, Canada,
3
Psychology Department, Concordia University, Montreal, QC, Canada
Previous research has shown that readiness to change and internal
motivation are important predictors of how well someone will do in
treatment for an anorexia nervosa (AN). However, studies on motivational
factors in those undergoing inpatient treatment are lacking. The aim of the
current study was to determine to what extent autonomous and controlled
motivation predict inpatient treatment outcome in individuals with Anorexia
Nervosa (AN). The sample consisted of 35 patients with AN admitted to
the Douglas Mental Health University Institute’s inpatient Eating Disorders
Program. Upon admission and discharge, participants were assessed for
levels of motivation, eating disorder symptoms, depression, and anxiety,
as well as BMI, and comorbid psychiatric diagnoses. Hierarchical multiple
regression analyses revealed that, after controlling for pre-treatment levels
of eating disorder symptoms, autonomous motivation was a significant
predictor of eating disorder symptomology scores at discharge (F (2,32) =
5.77,
p<.05), explaining 11.3% of the variance in discharge eating symptoms
scores. Controlled motivation did not emerge as a significant predictor of
outcome. Our results suggest that being motivated to undergo treatment
for internal reasons may be an important factor for reducing eating disorder
symptomatology in those undergoing inpatient treatment for AN.
F65
Prevalence of Pica Eating and Rumination Behavior Among
Adolescents and Adults Seeking Treatment for Eating Disorders and
Obesity
Jennifer J. Thomas
1,2
,
Andrea S. Hartmann
1,2,3
,
Helen F. Burton
1
,
Anne E.
Becker
1,2
,
Kamryn T. Eddy
1,2
1
Massachusetts General Hospital Eating Disorders Clinical & Research
Program, Boston, MA, USA,
2
Department of Psychiatry, Harvard Medical
School, Boston, MA, USA,
3
University of Osnabrück, Institute of Psychology,
Osnabrück, Germany
Introduction:
DSM-5
combines feeding disorders (FD) and eating disorders
(
ED) into a unified category, but little is known about their comorbidity.
We evaluated the prevalence of pica eating (persistent consumption of
non-nutritive substances) and rumination behavior (repeated regurgitation
followed by re-chewing or re-swallowing) among 250 patients seeking
ED or obesity treatment.
Methods:
We diagnosed
DSM-5
FD and ED via
structured interview among adolescent females from a residential ED unit (
N
= 150) and adults of both sexes from an outpatient obesity treatment center
(
N
= 100). We allowed for comorbidity by examining pica and rumination
behavior rather than full-blown FDs.
Results:
Pica eating was rare in both
the ED (4%) and obesity (4%) samples, with
pagophagia
(
i.e., large-scale
ice consumption) being the most common subtype. Because ED patients
often identified hunger as the primary rationale for pica eating, identifying
whether pica warranted independent clinical attention posed a diagnostic
challenge. Rumination behavior was more common in the ED (5%) than
the obesity treatment (1%) sample. In both groups, gastrointestinal distress
secondary to bingeing and/or purging complicated differential diagnosis.
Conclusions:
Our data suggest that a minority of individuals seeking ED
or obesity treatment exhibit pica eating and rumination behavior. Future
research is needed to identify the extent to which FD symptoms resolve with
traditional ED or obesity treatment.
F66
Psychological Implications of Refeeding: Are Adolescents with
Restrictive Eating Disorders “Stabilized” by Medical Stabilization
Protocols?
Abbigail M. Tissot
1,2,3
,
Jennifer B. Hillman
4
,
James Peugh
2,5
,
Emily K.
Verkamp
1
,
Laurie A. Mitan
1,3
,
Jenny Tong
3
1
Adolescent Medicine, Cincinnati Children’s Hospital Medical Center,
Cincinnati, OH, USA,
2
Behavioral Medicine and Clinical Psychology,
Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA,
3
University of Cincinnati College of Medicine, Cincinnati, OH, USA,
4
Washington University in St. Louis, St. Louis, MO, USA,
5
Biostatistics and
Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH,
USA
Purpose
:
Restrictive eating disorders (ED) are often identified when
starvation causes medical instability. Refeeding (5-7 days of inpatient
nutrition) is a first line treatment to stabilize the individual. Though largely
unresearched, psychological processes of refeeding are anecdotally
implicated in outcomes. This study examined psychological states in ED
pre- and post-refeeding and in comparison to controls.
Methods
:
Female
adolescents with newly diagnosed ED were recruited within 24 hours of
admission for stabilization (
n
=15; Age=15.53); matched healthy controls
were recruited. 150-minute meal tolerance tests (MTT) with ecological
momentary assessment of psychological states were completed at
admission and discharge. Error bar plots were used to compare MTT
profiles; area under the curve (AUC) quantified changes within (ED-
Admission vs ED-Refed) and between groups (ED-Admission, ED-Refed vs
Controls).
Results
:
Only pain improved with refeeding of ED. Surprisingly,
hunger, olfaction, taste, positive affect, and weight preoccupation (but not
dissatisfaction) were worsened by refeeding. Per AUC, psychological states
were not significantly modified pre- to post-refeeding. Moreover, significant
differences in psychological states remained between ED and controls
after refeeding.
Conclusions
:
Refeeding reduced meal-related pain, but
intensified other maladaptive psychological responses to eating. Our results
raise questions about the adequacy of acute stabilization protocols.
F67
A Randomized Controlled Trial of Motivational Interviewing for Binge
Eating
Rachel A. Vella-Zarb
1
,
Jennifer S. Mills
1
,
Henny A. Westra
1
,
Jacqueline C.
Carter
2
1
York University, Toronto, ON, Canada,
2
Memorial University, St. John’s, NL,
Canada
Introduction:
Motivational Interviewing (MI) is a collaborative therapy that
focuses on strengthening a person’s internal motivation to change. Prior
research suggests that MI may be helpful for treating binge eating. This
study built on previous research by comparing MI to psychoeducation as
a prelude to cognitive-behavioural self-help for binge eating.
Methods:
Participants with full or subthreshold DSM-IV Binge Eating Disorder (BED)
or nonpurging Bulimia Nervosa (BN-NP) were randomly assigned to
receive either 60 minutes of MI + a self-help manual (
n =
24)
or 60 minutes
of psychoeducation + a self-help manual (
n
= 21). Questionnaires were
completed pre- and post-session, as well as at 1 month and 4 months
POSTER SESSION 2 ABSTRACTS
