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Bethesda, Maryland | September 19-21, 2013
follow-up. Changes in readiness to change, self-efficacy, eating disorder
symptoms, self-esteem, and depression were examined.
Results:
MI
significantly increased readiness to change and self-efficacy from pre-
to post-session, whereas psychoeducation did not. Participants in the
MI condition reported a significantly stronger therapeutic alliance than
did participants in the psychoeducation condition. Both groups showed
significant improvements in overall eating disorder symptoms, binge eating
frequency and severity, and self-esteem from baseline to 1- and 4-month
follow-ups; however, no group differences on these measures over time
were identified.
Conclusions:
These findings demonstrate the usefulness
of incorporating MI into the treatment of binge eating.
F68
Therapists’ Attitudes to the Use of Treatment Manuals with Patients
with Eating Disorders: The Role of Knowledge, Experience and
Emotions
Glenn Waller
1
,
Victoria Mountford
2,3
,
Madeleine Tatham
4
,
Hannah Turner
5
,
Chloe Gabriel
6
,
Rebecca Webber
1
1
University of Sheffield, Sheffield, United Kingdom,
2
King’s College London,
London, United Kingdom,
3
South London and Maudsley NHS Foundation
Trust, London, United Kingdom,
4
Norfolk Community Eating Disorders
Service, Norwich, United Kingdom,
5
Southampton Eating Disorders
Service, Southampton, United Kingdom,
6
University of Aston, Birmingham,
United Kingdom
Background:
Therapists use treatment manuals infrequently with the
eating disorders, despite evidence of their enhancing therapy. This study
explores the way in which clinicians’ knowledge and experience of manuals
and emotional features influence both positive and negative attitudes to our
use of such manuals.
Method:
120
eating disorder therapists completed a
measure of attitudes to the use of manuals in psychotherapy. Positive and
negative attitudes were associated with demographic factors, experience
of manual use, knowledge about manuals, and mood.
Results:
Attitudes
were not related to therapist gender or therapeutic orientation. However,
negative attitudes were associated with the beliefs that manuals exclude
individualised case conceptualisation and that they are imposed for cost
control purposes. Positive attitudes to manuals were more likely when
the clinician saw them as linking theory and treatment and had a clear
idea of what a manual was. However, clinician depression level was
linked with less positive attitudes.
Conclusions:
Distinct factors drove
positive and negative attitudes to manuals, including beliefs about what
they contain and the clinicians’ own levels of low mood. There is a clear
need to enhance clinicians’ knowledge of what treatment manuals contain
and the principles behind them. However, it might also be important to
address some clinicians’ own mood/self-esteem levels in order to reduce
perceptions of helplessness and lack of efficacy.
F
69
Effectiveness of Exposure Techniques to Improve Body Image and
Food Craving in Bulimia Nervosa
Cortney Warren
3
,
Sandra Diaz
1
,
Blanca Ortega
1
,
Sonia Rodriguez
1
,
Silvia
Moreno
2
,
MCarmen Fernandez
1
1
University of Granada, Granada, Spain,
2
University of Jaen, Jaen, Spain,
3
University of Nevada, Las Vegas, NV, USA
Introductio
n Body exposure is an important technique used to reduce
body dissatisfaction in women with eating disorders. However, the
psychological processes underlying the two most prominently used mirror
exposure techniques (i.e., pure exposure [PE] and guided exposure
[
GE]) remain unclear. This study evaluated the effectiveness of these two
therapeutic interventions to improve body image and food-related emotions
and cognitions.
Method
Twenty-nine university women with high body
dissatisfaction and bulimic symptoms were randomly assigned to one of
the two mirror exposure conditions: PE (N =14) or GE (N =15). participants
received six 50 min exposure sessions twice a week. Dependent variables
were subjective changes in negative mood state, food craving, positive
thoughts, and satisfaction with one’s own body taken at three times
:
(
a)
before treatment, (b) after treatment, and (c) one month after treatment.
Results
No significant differences were found between the two exposure
groups on any outcome measures. Specifically, engaging in PE or GE
resulted in a progressive and significant decrease of negative mood
and food craving. Furthermore, the frequency of positive thoughts and
satisfaction with one’s own body increased after treatment and at 1-month
follow-up.
Conclusions
These findings indicate that both PE and GE
mirror exposure techniques can be considered effective to boost emotions
and cognitions related to body image and food craving in women with
bulimia nervosa.
F70
Appearance-Related Anxiety and Body Checking Behavior in
Nonclinical College Men
Emily K. White, Cortney S. Warren
University of Nevada Las Vegas, Las Vegas, NV, USA
Anxiety and eating pathology commonly co-occur in women, but the
correlates of disordered eating are less well understood in men. Thus the
purpose of this study was to examine the associations between various
forms of anxiety (i.e., social appearance anxiety; social physique anxiety),
eating pathology, and body checking behaviors in men. Male college
students (
N
=337) with no eating disorder history completed self-report
measures in an online format and received course credit for participation.
We tested the fit of a hypothesized path model in which eating pathology
predicted body checking cognitions; cognitions predicted social anxiety (in
the forms of social appearance anxiety and social physique anxiety), and
body checking behavior; and body checking behavior predicted clinical
impairment. Results of path analysis suggested adequate fit between the
hypothesized model and data (CFI=.903; RMSEA=.10). Beliefs about the
function or utility of body checking predicted body checking behavior, and
social appearance anxiety was a stronger predictor of body checking than
social physique anxiety. This nonclinical sample of men also reported
significant clinical impairment associated with body checking. Overall,
results identify three correlates of body checking behavior in men:
concerns about one’s overall appearance; beliefs about the function of
body checking; and clinical impairment. These associations have clinical
implications for comorbid eating and anxiety pathology.
F71
Genetic Factors Contributing to Low Body Weight in Anorexia
Nervosa
Zeynep Yilmaz
1,2
,
Allan S. Kaplan
1,2,3
,
Arun K. Tiwari
3,4
,
Robert D.
Levitan
1,3,5
,
Sara Piran
6
,
Jo Knight
1,4
,
James L. Kennedy
1,3,4
,
Price
Foundation Consortium
.
1
Institute of Medical Science, University of Toronto, Toronto, ON, Canada,
2
Clinical Research Department, Centre for Addiction and Mental Health,
Toronto, ON, Canada,
3
Department of Psychiatry, University of Toronto,
Toronto, ON, Canada,
4
Neurogenetics Section, Centre for Addiction
and Mental Health, Toronto, ON, Canada,
5
Mood and Anxiety Program,
Centre for Addiction and Mental Health, Toronto, ON, Canada,
6
Faculty of
Medicine, University of Ottawa, Ottawa, ON, Canada
Low weight or body mass index (BMI) is the
sine qua non
of anorexia
nervosa (AN), and
low weight and behaviours associated with reaching
it are the primary reason for the high morbidity and mortality in this
illness. The purpose of this study is to determine the role of candidate
genes selected from the leptin, melanocortin and neurotrophin systems
in sustained low body weight in AN. Only AN probands without bulimia
nervosa (BN) history and BN probands without AN history are included
in the analysis, reducing phenotypic heterogeneity within groups and
increasing diagnostic differences between groups. The sample consisted of
745
AN cases, 245 BN cases and 321 female controls. Our results showed
that an
MC4R
variant previously linked to antipsychotic-induced weight
gain may be underrepresented in AN. Furthermore,
AGRP
was associated
with minimum BMI in AN, and a
NTRK3
risk variant was linked to maximum
BMI in BN. To our knowledge, this is the first study to address the issue
of high crossover rates in eating disorders being a possible confound in
genetic studies, and to explore the role of markers with known or putative
function in genes involved in appetite and weight in AN and BN. These
genetic findings may serve as an important first step toward gaining a
better understanding of weight regulation in eating disorders, as well as
having the potential for developing more effective treatment options and
providing a highly specific target for the development of novel medications.
F72
Childhood Externalizing Trajectories Predict Disordered Eating in
Adolescent Girls
Stephanie C. Zerwas, Ann Von Holle, Cynthia Bulik
UNC Center of Excellence for Eating Disorders, Chapel Hill, NC, USA
Introduction.
Externalizing behavior in childhood has been an
understudied risk factor for the development of disordered eating in
adolescence. To our knowledge here are no studies that examine
trajectories of childhood externalizing behavior and adolescent disordered
eating.
Method.
We examined data from the prospective longitudinal
NICHD Study of Early Child Care and Youth Development (N=562 girls).
Child externalizing behavior was assessed yearly (24 months–12 years)
via maternal report on the CBCL. Disordered eating behaviors were
assessed at 15 years via self-report on the Eating Attitudes Test (EAT).
EAT risk threshold was defined as a score >10. We used Latent Growth
Mixture Modeling to test our hypotheses. In LGMM, each child is assigned
to a latent anxiety trajectory class via probabilistic assignment. We
hypothesized that girls in the high stable group would have the highest
risk of disordered eating.
Results.
The best fitting model included three
trajectories of childhood externalizing behavior, low stable (23.6% of girls),
high but decreasing (59.3% girls) and high stable (17.1% girls) trajectories.
Girls in the high stable trajectory class had significantly increased odds
of disordered eating in comparison to the high decreasing and low stable
anxiety trajectory class (OR=3.00, p<.05 & OR=1.5, p<.05, respectively).
Conclusions.
Results will be discussed with respect to role of externalizing
behavior including executive function for disordered eating behaviors.
POSTER SESSION 2 ABSTRACTS
