Anorexia Nervosa and Bulimic Disorders (eBook)

Front Cover 1
Anorexia Nervosa and Bulimic Disorders: Current Perspectives 6
Copyright Page 7
Table of Contents 10
Dedication Page 5
Preface 8
Section 1: HISTORICAL ASPECTS 16
Chapter 1. RICHARD MORTON, 1637-1698, LIMNER OF ANOREXIA NERVOSA: HIS LIFE AND TIMES A TERCENTENARY ESSAY 18
INTRODUCTION 18
REFERENCES 22
Chapter 2. ASCETIC IDEALS AND ANOREXIA NERVOSA 24
REFERENCES 29
Chapter 3. ARCHIVAL EXPLORATION OF ANOREXIA NERVOSA 30
INTRODUCTION 30
HISTORICAL BACKGROUND 30
HISTORICAL SOURCES 31
RESEARCH METHOD 31
RESULTS 32
DISCUSSION AND CONCLUSIONS 34
REFERENCES 35
Chapter 4. THE CHANGING NATURE OF ANOREXIA NERVOSA: AN INTRODUCTION TO THE CONFERENCE 36
EVIDENCE OF CHANGES IN ANOREXIA NERVOSA 37
DISCUSSION AND CONCLUSIONS 41
REFERENCES 43
Section 2: CLASSIFICATION 46
Chapter 5. CLASSIFICATION OF THE EATING DISORDERS 48
REFERENCES 54
Chapter 6. SUBGROUPS OF ANOREXIA NERVOSA AND BULIMIA: VALIDITY AND UTILITY 56
INTRODUCTION 56
METHOD 56
RESULTS 57
DISCUSSION 62
REFERENCES 62
Chapter 7. SIMILARITIES AMONG BULIMIC GROUPS SELECTED BY DIFFERENT WEIGHTS AND WEIGHT HISTORIES 64
INTRODUCTION 64
METHODS 65
RESULTS 65
DISCUSSION 68
REFERENCES 69
Chapter 8. THE SIGNIFICANCE OF THE BULIMIA NERVOSA 70
INTRODUCTION 70
METHOD 71
RESULTS 71
DISCUSSION 74
REFERENCES 74
Section 3: EPIDEMIOLOGICAL ASPECTS 76
Chapter 9. THE EPIDEMIOLOGY OF ANOREXIA NERVOSA AND BULIMIA 78
THE DETECTION OF CASES 79
SEARCHING FOR CAUSES 84
PREVENTION 86
CONCLUSIONS 86
REFERENCES 86
Chapter 10. PATTERNS OF CARE OF ANOREXIA NERVOSA 90
INTRODUCTION 90
METHODS 90
PATTERNS OF CARE 91
CHARACTERISTICS 92
DISCUSSION 94
REFERENCES 95
Chapter 11. THE PREVALENCE OF BINGE-EATING AND BULIMIA IN 1063 COLLEGE STUDENTS 96
INTRODUCTION 96
SUBJECTS AND METHODS 97
RESULTS 98
DISCUSSION 99
REFERENCES 101
Chapter 12. ANOREXIA NERVOSA IN GLASGOW 102
INTRODUCTION 102
METHOD 102
RESULTS 102
DISCUSSION 104
REFERENCES 105
Chapter 13. SOCIAL CLASS AS A CONFOUNDING VARIABLE IN THE EATING ATTITUDES TEST 106
INTRODUCTION 106
METHOD 107
PROCEDURE 107
RESULTS 107
DISCUSSION 109
REFERENCES 111
Chapter 14. THE IMPLICATIONS OF ANOREXIA NERVOSA IN ABALLET SCHOOL 112
INTRODUCTION 112
SUBJECTS 112
METHODS 112
RESULTS 113
DISCUSSION 115
REFERENCES 116
Chapter 15. ANOREXIA NERVOSA IN AMERICAN BLACKS 118
INTRODUCTION 118
PATIENTS AND METHODS 118
DISCUSSION 122
REFERENCES 123
Section 4: BIOLOGICAL ASPECTS 124
Chapter 16. NEUROBIOLOGICAL ASPECTS OF FEEDING DISORDERS 126
INTERACTION BETWEEN BIOLOGICAL AND PSYCHOLOGICAL FACTORS 126
NEUROENDOCRINE CHANGES IN ANOREXIA NERVOSA 127
NEUROTRANSMITTER MONOAMINES IN ANOREXIA NERVOSA 132
BULIMIA 133
CONCLUSIONS 134
REFERENCES 134
Chapter 17. DEXAMETHASONE SUPPRESSION AND ENERGY BALANCE: A STUDY OF ANOREXIC PATIENTS 138
INTRODUCTION 138
PATIENTS AND METHODS 138
RESULTS 140
DISCUSSION 141
REFERENCES 141
Chapter 18. GASTROINTESTINAL HORMONES IN ANOREXIA NERVOSA 142
METHOD 143
RESULTS 144
DISCUSSION 147
REFERENCES 148
Chapter 19. THE TRH TEST IN BULIMIA AND ANOREXIA NERVOSA: A CONTROLLED STUDY 150
METHOD 151
RESULTS 151
DISCUSSION 153
REFERENCES 154
Chapter 20. ANOREXIA NERVOSA AND THE ADRENAL: THE EFFECT OF WEIGHT GAIN 156
INTRODUCTION 156
METHODS 156
RESULTS 157
DISCUSSION 159
REFERENCES 159
Chapter 21. EVALUATION OF GROWTH IN ANOREXIA NERVOSA FROM SERIAL MEASUREMENTS 162
INTRODUCTION 162
SUBJECTS 162
METHODS 163
RESULTS 163
DISCUSSION 164
REFERENCES 164
Chapter 22. THE NEURONAL BASIS OF COMPULSIVE BEHAVIOUR IN ANOREXIA NERVOSA 166
COMPULSIVE BEHAVIOUR 167
EXCESSIVE MENTAL AROUSAL 168
NALOXONE THERAPY 169
REFERENCES 170
Section 5: FAMILIAL ASPECTS 172
Chapter 23. A CONTROLLED FAMILY STUDY OF ANOREXIA NERVOSA 174
INTRODUCTION 174
METHODS 175
RESULTS 177
DISCUSSION 179
REFERENCES 180
Chapter 24. FAMILY STRUCTURE AND BIRTH ORDER OF PATIENTS WITH ANOREXIA NERVOSA 182
INTRODUCTION 182
METHOD 183
RESULTS 183
DISCUSSION 184
REFERENCES 185
Section 6: PSYCHOLOGICAL ASPECTS 188
Chapter 25. A REVIEW OF BODY-IMAGE STUDIES IN ANOREXIA NERVOSA AND BULIMIA NERVOSA 190
INTRODUCTION 190
EXPERIMENTAL METHODS FOR STUDYING BODY-IMAGE 191
DIAGNOSTIC/COMPARATIVE STUDIES 192
RELIABILITY STUDIES 194
FACTORS AFFECTING ESTIMATION/DISTORTION ERRORS 195
SUB-GROUP DIFFERENCES 196
RELATIONSHIP TO OUTCOME/PROGNOSIS 196
THEORETICAL, CLINICAL AND RESEARCH IMPLICATIONS 197
REFERENCES 200
Chapter 26. PSYCHOLOGICAL CORRELATES OF WEIGHT GAIN IN PATIENTS WITH ANOREXIA NERVOSA 202
INTRODUCTION 202
METHOD 202
RESULTS 203
DISCUSSION 205
REFERENCES 206
Chapter 27. SYMBOLIC FUNCTIONING IN ANOREXIA NERVOSA 208
INTRODUCTION 208
METHOD 209
RESULTS 209
DISCUSSION 210
REFERENCES 213
Chapter 28. SATIETY RESPONSES IN EATING DISORDERS 214
SATIETY RESPONSES IN EATING DISORDERS 214
METHODS 214
RESULTS 215
DISCUSSION 219
REFERENCES 219
Chapter 29. THE DISCRIMINATIVE VALUE OF PSYCHOLOGICAL CHARACTERISTICS IN ANOREXIA NERVOSA. CLINICAL AND PSYCHOMETRIC COMPARISON BETWEEN ANOREXIA NERVOSA PATIENTS, BALLET DANCERS AND CONTROLS 220
INTRODUCTION 220
METHOD 221
RESULTS 222
DISCUSSION 224
REFERENCES 225
Chapter 30. PERSONAL CONSTRUCTS IN ANOREXIA 226
INTRODUCTION 226
METHOD 227
RESULTS 228
DISCUSSION 230
CONCLUSION 230
REFERENCES 230
Chapter 31. EMPIRICAL ASSESSMENT OF IDENTITY IN ANOREXIA AND BULIMIA NERVOSA 232
INTRODUCTION 232
DEVELOPMENT AND APPLICATION OF ISA 233
POTENTIAL CONTRIBUTIONS OF ISA 234
IDENTITY CHARACTERISTICS OF ANOREXICS AND BULIMICS 235
CONCLUSIONS 236
REFERENCES 236
Section 7: ANOREXIA NERVOSA IN THE MALE 238
Chapter 32. ANOREXIC SYNDROMES IN THE MALE 240
INTRODUCTION 240
METHOD 240
RESULTS 241
DISCUSSION 246
REFERENCES 247
Chapter 33. ANOREXIA NERVOSA IN THE MALE: CLINICAL FEATURES AND FOLLOW-UP OF NINE PATIENTS 250
INTRODUCTION 250
RESULTS 251
DISCUSSION 253
REFERENCES 255
Chapter 34. FACTORS AFFECTING PROGNOSIS IN MALE ANOREXICS 258
INTRODUCTION 258
METHOD 258
RESULTS 259
DISCUSSION 260
REFERENCES 262
Section 8: BULIMIA 264
Chapter 35. MOOD AND FOOD: AN ANALYSIS OF BULIMIC EPISODES 266
INTRODUCTION 266
METHOD 266
RESULTS 267
DISCUSSION 269
REFERENCES 270
Chapter 36. CONTROLLING WEIGHT BY PURGATION AND VOMITING: A COMPARATIVE STUDY OF BULIMICS 272
INTRODUCTION 272
METHODS 272
RESULTS 273
DISCUSSION 274
REFERENCES 276
Chapter 37. BULIMIA: MULTIVARIATE PREDICTORS OF LIFE IMPAIRMENT 278
INTRODUCTION 278
METHOD 278
RESULTS 279
DISCUSSION 280
REFERENCES 282
Chapter 38. THE PREDICTION OF RELAPSE IN BULIMIA NERVOSA 284
INTRODUCTION 284
METHOD 284
RESULTS 286
DISCUSSION 287
REFERENCES 288
Section 9: GENERAL CLINICAL ASPECTS 290
Chapter 39. ADVERSE SEXUAL EXPERIENCE IN CHILDHOOD AND CLINICAL EATING DISORDERS:A PRELIMINARY DESCRIPTION 292
INTRODUCTION 292
METHOD 292
RESULTS 293
DISCUSSION 294
REFERENCES 296
Chapter 40. PREMENARCHAL ANOREXIA NERVOSA AND ITS SEQUELAE 298
INTRODUCTION 298
PATIENTS AND METHODS 299
RESULTS 301
CONCLUSIONS 302
REFERENCES 303
Chapter 41. EVALUATION OF INPATIENT TREATMENT OF ADOLESCENT ANOREXIC PATIENTS 306
INTRODUCTION 306
SAMPLE 307
METHODS 307
RESULTS 308
DISCUSSION 310
REFERENCES 310
Chapter 42. ANOREXIA NERVOSA, BULIMIA AND ALCOHOLISM–ASSOCIATIONOF EATING DISORDER AND ALCOHOL 312
INTRODUCTION 312
DISCUSSION 314
REFERENCES 315
Chapter 43. ANOREXIA NERVOSA AND BULIMIA IN FEMALE ADOLESCENTS WITH INSULIN DEPENDENT DIABETES MELLITUS: A SYSTEMATIC STUDY 316
INTRODUCTION 316
PATIENTS AND METHODS 316
RESULTS 317
DISCUSSION 317
Chapter 44. WHY DO SOME ANOREXICS STEAL? PERSONAL, SOCIAL AND ILLNESS FACTORS 320
INTRODUCTION 320
METHOD 321
RESULTS 322
DISCUSSION 324
REFERENCES 325
Section 10:TREATMENT 326
Chapter 45. A TREATMENT APPROACH TO ANOREXIA NERVOSA—25 YEARS ON 328
INTRODUCTION 328
SPECIFIC PHYSICAL TREATMENTS 337
RESULTS OF TREATMENT 338
REFERENCES 339
Chapter 46. THE TREATMENT OF ANOREXIA NERVOSA IN TORONTO 340
ANOREXIA NERVOSA AS A MULTIDIMENSIONAL DISORDER 342
THE EFFECTS OF STARVATION 342
DIFFERENCES BETWEEN BULIMICS AND RESTRICTERS 343
THE RELATIONSHIP BETWEEN EATING AND AFFECTIVE DISORDER 344
OUTCOME STUDIES 344
REFERENCES 345
Chapter 47. INPATIENT TREATMENT OF ANOREXIA NERVOSA: SOME RESEARCH-GUIDED CHANGES 348
CHANGES IN THE TREATMENT PROGRAM 348
THE MOTIVES FOR CHANGE 350
THE MULTIFACETED GROUP APPROACH 353
CONCLUSION 356
REFERENCES 356
Chapter 48. INDIVIDUAL PSYCHOTHERAPY FOR ANOREXIA NERVOSA 358
RECENT POINTS OF EMPHASIS IN INDIVIDUAL PSYCHOTHERAPY 359
BEHAVIORAL METHODS 361
COGNITIVE METHODS 362
EDUCATIONAL METHODS 362
PSYCHODYNAMIC METHODS 362
MULTIDIMENSIONAL THERAPY 363
RE-EMERGENT THEMES IN PSYCHOTHERAPY 363
CONTRAINDICATIONS FOR INDIVIDUAL PSYCHOTHERAPY 364
THE CHANGING PATIENT POPULATION 364
EVALUATION OF INDIVIDUAL PSYCHOTHERAPY 365
REFERENCES 365
Chapter 49. THE FAMILY THERAPY OF ANOREXIA NERVOSA 370
INTRODUCTION 370
AETIOLOGICAL CONSIDERATIONS 371
DESCRIPTIONS OF FAMILIES 372
THE MOBILIZATION OF FAMILY THERAPY 376
REFERENCES 377
Chapter 50. TREATMENT OF EATING DISORDERS: WINNING THE WAR WITHOUT HAVING TO DO BATTLE 380
Chapter 51. CORRECTING THE EATING DISORDER IN ANOREXIA NERVOSA 384
INTRODUCTION 384
SUBJECTS AND METHODS 384
RESULTS 385
DISCUSSION 385
REFERENCES 386
Chapter 52. REVIEW OF A GROUP FOR PARENTS OF ANOREXICS 388
INTRODUCTION 388
GROUP PROCESS 389
THEMES 389
EVALUATION OF THE GROUP 390
DISCUSSION 391
CONCLUSION 392
REFERENCES 392
Chapter 53. OCCUPATIONAL THERAPY IN ANOREXIA NERVOSA 394
INTRODUCTION 394
AIMS OF OCCUPATIONAL THERAPY IN THE TREATMENT OF ANOREXIA NERVOSA 394
OCCUPATIONAL THERAPY ACTIVITIES 395
CONCLUSION 398
REFERENCES 398
Chapter 54. THE MANAGEMENT OF BULIMIA NERVOSA 400
INTRODUCTION 400
RESEARCH ISSUES 400
RESEARCH FINDINGS 402
CONCLUSIONS AND SOME PRACTICAL RECOMMENDATIONS 405
REFERENCES 406
Chapter 55. PSYCHOTHERAPY FOR BULIMIA: A CONTROLLED STUDY 408
INTRODUCTION 408
METHOD 408
RESULTS 410
DISCUSSION 412
REFERENCES 412
Chapter 56. EVALUATING A GROUP TREATMENT FOR BULIMIA 414
INTRODUCTION 414
METHOD 414
RESULTS 416
DISCUSSION 417
REFERENCES 418
Chapter 57. A DOUBLE-BLIND TRIAL OF PHENELZINE IN BULIMIA 420
INTRODUCTION 420
METHODS 420
RESULTS 421
CONCLUSION 423
REFERENCES 423
Section 11: OUTCOME AND PROGNOSIS 426
Chapter 58. OUTCOME AND PROGNOSIS IN ANOREXIA NERVOSA AND BULIMIA: SOME RESULTS OF PREVIOUS INVESTIGATIONS, COMPARED WITH THOSE OF A SWEDISH LONG-TERM STUDY 428
INTRODUCTION 428
PROBLEMS AND DIFFICULTIES IN INVESTIGATIONS OF OUTCOME AND PROGNOSIS 429
RESULTS OF A SWEDISH LONG-TERM FOLLOW-UP STUDY, COMPARED WITH PREVIOUS INVESTIGATIONS 436
THE SEARCH FOR PROGNOSTIC FACTORS 440
CONCLUDING REMARKS 441
REFERENCES 442
Chapter 59. THE TREATMENT AND OUTCOME OF ANOREXIA NERVOSA IN ADOLESCENTS: A PROSPECTIVE STUDY AND FIVE YEAR FOLLOW-UP 444
INTRODUCTION 444
THE PATIENT POPULATION 444
INITIAL ASSESSMENT 445
THE TREATMENT PROGRAM 445
TREATMENT RESULTS 445
FOLLOW-UP 445
PSYCHIATRIC SYMPTOMS 448
PROGNOSTIC FACTORS 448
DISCUSSION 448
REFERENCES 449
Chapter 60. DEATH AND RELAPSE IN ANOREXIA NERVOSA: SURVIVAL ANALYSIS OF 151 CASES 450
INTRODUCTION 450
STUDY GROUP AND METHODS 450
RESULTS 453
DISCUSSION 454
REFERENCES 456
INDEX 458