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Anorexia nervosa [keywords]
- Empathy and social functioning in anorexia nervosa before and after recovery. [JOURNAL ARTICLE]
- Cogn Neuropsychiatry 2013 May 22.
Introduction.People with anorexia nervosa (AN) are known to have difficulties with social and emotional functioning, as indicated by their symptom presentation and also performance on tests of emotion perception. This study explores the level of empathy in AN, in terms of resonant experience of emotion in other people using a self-report measure. Methods. Twenty-eight women with acute AN were compared to 25 women who have recovered from AN, and a further 54 healthy control (HC) participants. They were assessed using a questionnaire to measure reported levels of empathy, emotional recognition, social conformity, and antisocial behaviour.
Results.The acute AN group reported lower levels of empathy than the recovered AN group and HC, but they also reported less antisocial behaviour. No differences were found in emotional recognition or social conformity.
Conclusions.These results suggest that emotional empathy is reduced during acute AN. Lower levels of antisocial behaviour may reflect a contrasting desire of people with AN to minimise presentation of antisocial behaviour in the acute state.
- The Relationship Between Borderline Personality and Obesity. [JOURNAL ARTICLE]
- Innov Clin Neurosci 2013 Apr; 10(4):36-40.
Obesity is a significant health problem in the United States. Therefore, it is extremely important to understand potential clinical associations with obesity, including personality pathology. From studies of personality disorders in other types of eating pathology, it appears that restrictive personality disorders (e.g., obsessive-compulsive disorder) are associated with restrictive eating pathology (e.g., anorexia nervosa, restricting type) whereas impulsive personality disorders (e.g., borderline personality disorder) are associated with impulsive eating pathology (e.g., anorexia nervosa, binge-eating/purging type; bulimia nervosa, binge eating disorder). Because binge eating disorder is oftentimes associated with an obese status, it seems likely that borderline personality disorder may also be associated with obesity. At the present time, there appear to be nine accessible studies in this area, comprising 639 obese individuals. While rates of borderline personality disorder in these studies vary from 2.2 to 94.1 percent, 10 of 19 measures detected this disorder at rates of 25 percent or higher, and the average of all percentages is 26.9 percent. Findings appear to support the association between impulsive personality pathology and impulsive eating pathology, and underscore that a significant minority of obese individuals may suffer from borderline personality disorder.
- Evaluation of enhanced attention to local detail in anorexia nervosa using the embedded figures test; an FMRI study. [Journal Article]
- PLoS One 2013; 8(5):e63964.
The behavioural literature in anorexia nervosa and autism spectrum disorders has indicated an overlap in cognitive profiles. One such domain is the enhancement of local processing over global processing. While functional imaging studies of autism spectrum disorder have revealed differential neural patterns compared to controls in response to tests of local versus global processing, no studies have explored such effects in anorexia nervosa. This study uses functional magnetic resonance imaging in conjunction with the embedded figures test, to explore the neural correlates of this enhanced attention to detail in the largest anorexia nervosa cohort to date. On the embedded figures tests participants are required to indicate which of two complex figures contains a simple geometrical shape. The findings indicate that whilst healthy controls showed greater accuracy on the task than people with anorexia nervosa, different brain regions were recruited. Healthy controls showed greater activation in the precuneus whilst people with anorexia nervosa showed greater activation in the fusiform gyrus. This suggests that different cognitive strategies were used to perform the task, i.e. healthy controls demonstrated greater emphasis on visuospatial searching and people with anorexia nervosa employed a more object recognition-based approach. This is in accordance with previous findings in autism spectrum disorder using a similar methodology and has implications for therapies addressing the appropriate adjustment of cognitive strategies in anorexia nervosa.
- [Beauticians' eating attitudes and body attitudes.] [JOURNAL ARTICLE]
- Psychiatr Hung 2013; 28(1):70-76.
Some professional groups (models, actresses, ballet dancers, jockeys and athletes) are considered as risk populations for eating disorders and body image disorders. Beauticians may be a possible risk group, as their work is closely related to beauty and fashion. Measures: Eating disorders were assessed using the Eating Attitudes Test and the Eating Behaviour Severity Scale, body image measures included the Human Figure Drawings Test, the Body Dissatisfaction Subscale of the Eating Disorders Inventory, the Body Attitudes Test, and the Body Investment Scale.
Results:Questionnaire data of 276 subjects were analysed. The study sample comprised 128 beauticians from Transylvania (5 males, 123 females). This group was compared with a control group consisting of 148 subjects (25 males, 123 females). Such weight reducing methods as dieting, exercise, the use of appetite suppressants and diuretics were significantly more prevalent in the beautician group. Mean total score and the scores of the Dieting subscale of the Eating Disorders Inventory were significantly (p < 0.02) higher in the beautician group in comparison with the control group. The prevalence of clinical and subclinical eating disorders (2.4% subclinical bulimia nervosa and 1.6% subclinical anorexia nervosa) was significantly higher in the beautician group. Beauticians invest significantly (p < 0.0001) more money and time for body care.
Conclusion:The above results suggest that working in the beauty industry may represent an increased risk of developing eating disorders.
- Folie à Deux and Anorexia Nervosa: A Case Report. [Journal Article]
- J Neuropsychiatry Clin Neurosci 2013 Mar 1; 25(2):E56-7.
- The relationship between anorexia nervosa and body dysmorphic disorder. [JOURNAL ARTICLE]
- Clin Psychol Rev 2013 Apr 19; 33(5):675-685.
Anorexia nervosa (AN) and body dysmorphic disorder (BDD) are severe body image disorders that highly impair individuals in their daily functioning. They are discrete but overlapping nosological entities. In this review, we examine similarities between AN and BDD with regard to clinical, personality and demographic aspects, such as comorbidity, phenomenology, and treatment outcome. The review suggests that the two disorders are highly comorbid, and show similar ages of onset, illness trajectories, and comparable clinical and personality characteristics. However, important differences emerge in their responsiveness to psychosocial and psychopharmacological treatment, which are discussed. Clinical implications of these findings are summarized and directions for future research are delineated, with a focus on how current treatment components from each disorder may inform new interventions for both disorders.
- Distribution of Eating Disorders in Children and Adolescents Using the Proposed DSM-5 Criteria for Feeding and Eating Disorders. [JOURNAL ARTICLE]
- J Adolesc Health 2013 May 15.
PURPOSE:To determine the distribution of eating disorders (ED) in children and adolescents comparing the fourth edition of the Diagnostic and Statistical Manual (DSM) to the proposed fifth edition DSM criteria.
METHODS:A total of 215 consecutive patients (15.4 ± 3.3 years) presenting for initial ED evaluation to adolescent medicine physicians from six institutions were assigned ED diagnoses using current DSM-IV criteria as well as proposed DSM-5 criteria.
RESULTS:Diagnoses of anorexia nervosa and bulimia nervosa increased using the proposed DSM-5 criteria (from 30.0% to 40.0% and from 7.3% to 11.8%, p < .001). Approximately 14% of patients received the presumptive DSM-5 diagnosis of avoidant/restrictive food intake disorder. Cases of ED not otherwise specified decreased from 62.3% to 32.6% (p < .001).
CONCLUSIONS:Proposed DSM-5 criteria substantially decreased the frequency of ED not otherwise specified diagnoses and increased the number of cases of anorexia nervosa and bulimia nervosa in a population of young patients presenting for ED treatment. Avoidant/restrictive food intake disorder appears to be a significant diagnosis.
- Anorexia nervosa in a 14-year-old second-generation Hispanic adolescent boy. [Journal Article]
- J Child Adolesc Psychopharmacol 2013 May; 23(4):295-9.
- Women with anorexia nervosa should not be treated with estrogen or birth control pills in a bone sparing effect. [JOURNAL ARTICLE]
- Acta Obstet Gynecol Scand 2013 May 20.
Eating disorders is a prevalent, serious condition that affects, mainly young women. An early and enduring sign of anorexia is amenorrhea. There is no evidence for benefits of hormone therapy in patients with anorexia, however, hormone medication and oral contraceptives are frequently prescribed for young women with anorexia as a prevention against and treatment for low bone mineral density. The use of estrogens may create a false picture indicating that the skeleton is being protected against osteoporosis. Thus the motivation to regain weight, and adhere to treatment of the eating disorder in itself, may be reduced. The most important intervention is to restore the menstrual periods through increased nutrition. Hormone and oral contraceptive therapy should not be prescribed to young women with amenorrhea and concurrent eating disorders. This article is protected by copyright. All rights reserved.
- Stereotactic surgery for eating disorders. [Journal Article]
- Surg Neurol Int 2013; 4(Suppl 3):S164-9.
EATING DISORDERS (EDS) ARE A GROUP OF SEVERELY IMPAIRED EATING BEHAVIORS, WHICH INCLUDE THREE SUBGROUPS: anorexia nervosa (AN), bulimia nervosa (BN), and ED not otherwise specified (EDNOS). The precise mechanism of EDs is still unclear and the disorders cause remarkable agony for the patients and their families. Although there are many available treatment methods for EDs today, such as family therapy, cognitive behavioral therapy, medication, psychotherapy, and so on, almost half of the patients are refractory to all current medical treatment and never fully recover. For treatment-refractory EDs, stereotactic surgery may be an alternative therapy. This review discusses the history of stereotactic surgery, the modern procedures, and the mostly used targets of stereotactic surgery in EDs. In spite of the limited application of stereotactic surgery in ED nowadays, stereotactic lesion and deep brain stimulation (DBS) are promising treatments with the development of modern functional imaging techniques and the increasing understanding of its mechanism in the future.