Blunted cortisol response to stress in patients with eating disorders: Its association to bulimic features
ObjectiveClinical research on cortisol response to stress in patients with eating disorders has provided controversial and even contradictory results. As this might be the consequence of the inclusion in the studies of heterogeneous clinical populations, 3 highly selected samples were studied. MethodsDexamethasone suppression test was performed on 15 restricting anorexia nervosa patients without history of bulimia nervosa (BN), 17 BN patients with normal weight and no history of anorexia nervosa, and 22 healthy controls. Three days later, the Trier Social Stress Test was applied, and 8 saliva samples were collected along the trial for cortisol assessment. ResultsWhen the patients were consi…
Attitudes towards change mediate the effect of dissociation on psychopathological outcome in the treatment of eating disorders.
Objectives The study aimed to examine whether dissociation and attitudes towards change were associated with the psychopathology in patients with eating disorders (EDs) at 1-year follow-up. Method The study included 110 females with anorexia nervosa and bulimia nervosa (48 and 62 respectively). At the beginning of the study and 1 year later, they were assessed by means of the following questionnaires: Dissociative Experiences Scale, Attitudes Towards Change (ACTA), State-Trait Anxiety Inventory, Rosenberg Self-Esteem Scale, Beck Depression Inventory, Eating Attitude Test, Bulimic Investigatory Test Edinburgh and Body Shape Questionnaire (BSQ). Results No statistically significant difference…
Papel de la depresión y la impulsividad en la psicopatología de la bulimia nerviosa
Resumen Introduccion El presente estudio trato de analizar el papel de la depresion y la impulsividad en la psicopatologia de la bulimia nerviosa (BN). Materiales y metodos Se examino a 70 mujeres con un diagnostico de bulimia nerviosa basado en la cuarta revision del Manual diagnostico y estadistico de los trastornos mentales (DSM-IV), subtipo purgativo, para los sintomas relacionados con el trastorno de la conducta alimentaria, insatisfaccion corporal, sintomas afectivos, impulsividad y rasgos de personalidad. Para el analisis estadistico se utilizaron metodos de analisis factorial y de modelos de ecuaciones estructurales. Resultados La BN se presento como un proceso que incorporaba 5 dim…
Genetic and environmental contributions to perfectionism and its common factors
Abstract The aims of this study: (1) To evaluate the relative contributions of genetics and environment to perfectionism and it's two constructs: self-oriented, and socially prescribed perfectionism. (2) To clarify genetic and environmental common origins of both personal and social components. Methods: Participants were 258 pairs of adolescent Spanish twins. Socially prescribed and self-oriented perfectionism were assessed using the perfectionism subscale of the Eating Disorder Inventory. Statistics: univariate and bivariate twin models, according to sex. Results; Heritability of self-oriented perfectionism was 23% in boys and 30% in girls, and of socially prescribed perfectionism 39% in b…
Neurobiological and Clinical Variables Associated with Alcohol Abuse in Bulimia Nervosa
The study was aimed at analysing the reciprocal relationships of several clinical and neurobiological items in order to predict alcohol misuse in patients with bulimia nervosa (BN). Seventy BN patients and 70 healthy controls were assessed for depression, impulsivity, borderline personality traits and self-defeating behaviours using specific scales; serum cortisol and 24-hour urinary excretion of serotonin and 5-hydroxiindolacetic acid were also assessed. The study confirmed the implications of these clinical factors for alcohol misuse in BN patients, but the results suggested that depressive symptoms and hypercortisolism could lie behind these relationships.
Los trastornos de la conducta alimentaria: consideraciones sobre nosología, etiopatogenia y tratamiento en el siglo xxi
Resumen Desde la primera conferencia internacional sobre los trastornos alimentarios, celebrada en los anos 70, hasta la actualidad, el desarrollo de las ciencias medicas ha sido sorprendente. En el campo de los trastornos de la conducta alimentaria (TCA) tambien se han producido cambios notables. En las fechas iniciales practicamente solo se hacia mencion de la anorexia nerviosa y sus posibles factores hipotalamicos y endocrinos; no habia estudios epidemiologicos ni ensayos controlados con psicofarmacos o psicoterapia. El panorama actual es bien diferente aunque hay carencias importantes que afectan a la propia nosografia de estas patologias, al conocimiento de sus bases neurobiologicas y …
The role of depression and impulsivity in the psychopathology of bulimia nervosa.
Introduction: The study aimed to analyze the role of depression and impulsivity in the psychopathology of bulimia nervosa (BN). Materials and methods: Seventy female patients with DSM-IV BN, purging subtype, were assessed for eating-related symptoms, body dissatisfaction, affective symptoms, impulsivity, and personality traits. Factor analysis and structural equation modeling methods were used for statistical analysis. Results: BN appeared as a condition which incorporated 5 general dimensions: a) binge eating and compensatory behaviours; b) restrictive eating; c) body dissatisfaction; d) dissocial personality traits; and e) a cluster of features which was called "emotional instability" The…
The role of temperament and character in the outcome of depressive mood in eating disorders.
Abstract Objectives The aims were to see which temperament and character dimensions were associated with depression, mainly with its outcome at two-year follow up in eating disorders (EDs). Methods Participants (N = 151) were 44 Anorexia nervosa (AN), 55 Bulimia nervosa (BN) and 52 Eating disorders not otherwise specified (EDNOS) patients. The Beck Depression Inventory (BDI), State and Trait Anxiety Inventory (STAI), Rosenberg Self Esteem Questionnaire (RSE), Eating Disorder Inventory (EDI-2) and Temperament and Character Inventory (TCI) were administered. Results Depression at the beginning (t0) was severe in 22% of the cases. Harm Avoidance and Novelty Seeking had an effect on depressed m…
Influence of Attitudes towards Change and Self-directness on Dropout in Eating Disorders: A 2-Year Follow-up Study
Objective This study examined dropout-related factors at the Outpatient Eating Disorders Treatment Programme. Method One hundred ninety-six eating disorders patients following DSM-IV diagnostic criteria that consecutively commenced treatment were recruited and followed up for a 2-year period. A total of 151 patients completed the whole assessment with a set of questionnaires evaluating eating and general psychopathology. The Attitudes towards Change in Eating Disorders questionnaire was used, and personality was evaluated using the Temperament and Character Inventory. During the follow-up period, patients were re-assessed. Two years later, 102 patients continued on treatment. Results Scores…
Prevalence and comorbidity of eating disorders among a community sample of adolescents: 2-year follow-up
The previous literature about comorbidity between eating disorders (ED) and other DSM-IV psychiatric disorders in adolescence has employed cross-sectional studies with clinical samples, where the comorbid disorders were diagnosed retrospectively. The present study aims to overcome these limitations by the analysis of comorbidity in a community population during 2-year follow-up. A semi-structured interview was applied to a teenager sample. Firstly, a cross-sectional and nonrandomized study on psychiatric morbidity was conducted with 993 teenagers between the ages of 12 and 16 from five schools. Secondly, 326 students between 14 and 17 years old of one school were reassessed 2 years later in…