What Constitutes Clinically Significant Binge Eating? Association Between Binge Features and Clinical Validators in College-Age Women.

What constitutes clinically significant binge eating? Association between binge features and clinical validators in college-age women.

Filed under: Eating Disorders

Int J Eat Disord. 2013 Feb 6;
Vannucci A, Theim KR, Kass AE, Trockel M, Genkin B, Rizk M, Weisman H, Bailey JO, Sinton MM, Aspen V, Wilfley DE, Taylor CB

OBJECTIVE: To investigate the association between binge features and clinical validators. METHOD: The Eating Disorder Examination assessed binge features in a sample of 549 college-age women: loss of control (LOC) presence, binge frequency, binge size, indicators of impaired control, and LOC severity. Clinical validators were self-reported clinical impairment and current psychiatric comorbidity, as determined via a semistructured interview. RESULTS: Compared with women without LOC, those with LOC had significantly greater odds of reporting clinical impairment and comorbidity (ps < 0.001). Among women with LOC (n = 252), the indicators of impaired control and LOC severity, but not binge size or frequency, were associated with greater odds of reporting clinical impairment and/or comorbidity (ps < 0.05). CONCLUSIONS: Findings confirm that the presence of LOC may be the hallmark feature of binge eating. Further, dimensional ratings about the LOC experience-and possibly the indicators of impaired control-may improve reliable identification of clinically significant binge eating. © 2013 by Wiley Periodicals, Inc. (Int J Eat Disord 2013). HubMed – eating


Understanding the ‘guide’ in guided self-help for disordered eating: A qualitative process study.

Filed under: Eating Disorders

Psychol Psychother. 2013 Mar; 86(1): 86-104
Traviss GD, Heywood-Everett S, Hill AJ

Objectives. This study aimed to explore how guidance contributes to the outcome of self-help for disordered eating. Method. A sample of guides and clients with a range of disordered eating was interviewed on completion of a randomized control trial and analysed using thematic framework analysis. Results. Four themes emerged; the necessity of having a guide as a facilitator, features of the therapeutic relationship in clients with positive outcomes, features of the therapeutic relationship in clients with poor outcomes, and client suitability. Conclusions. These findings have implications for the delivery of guided self-help interventions for disordered eating. They suggest the value of assessing clients’ readiness to change, working with clients with less severe and complex conditions, and the importance of guide qualities and skills. PRACTITIONER POINTS: •? Guidance is a necessary adjunct to self-help approaches for the effective treatment of a range of disordered eating and can be delivered by trained non-eating disorder specialists. •? Guided self-help appears most appropriate for less severe, binge-related eating disorders, including eating disorders not otherwise specified (EDNOS), further work is needed for use with anorexic-type presentations. •? While it is important to establish and maintain a strong, open, and collaborative therapeutic relationship, client ‘readiness’ appears fundamental in the relationship and consequent treatment outcome.
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Comorbidity-independent risk for suicidality increases with bulimia nervosa but not with anorexia nervosa.

Filed under: Eating Disorders

J Psychiatr Res. 2013 Feb 2;
Bodell LP, Joiner TE, Keel PK

BACKGROUND: Eating disorders are serious psychiatric illnesses with high levels of suicidality and high comorbidity. However, no study has established the extent to which suicidality is uniquely associated with eating disorders rather than attributable to comorbid mood, anxiety, or substance use disorders. The current study examined whether unique associations between eating disorders and suicidality exist and whether potential associations differ by eating disorder diagnosis. METHODS: Participants were women (n = 364) from the second stage of a large epidemiological study examining eating and health related attitudes and behaviors. The Structured Clinical Interview for Axis I diagnoses (SCID-I) was used to determine lifetime psychiatric diagnoses and lifetime suicidality. RESULTS: A multiple regression model including eating and comorbid disorders indicated that bulimia nervosa (BN) was significantly associated with suicidality above and beyond risk predicted by comorbid disorders. No unique association was found for anorexia nervosa (AN) or eating disorder not otherwise specified while controlling for comorbidity. CONCLUSIONS: BN is independently associated with suicidality, and findings emphasize the need to incorporate suicide risk assessment in standardized assessments of eating disorders.
HubMed – eating


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