Treatments between individual and group · Family – based

Treatments

·        
Cognitive
Behavior Therapy (CBT)

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o  
30%
– 40% symptom free

o  
Effective
for some, not all

o  
Not enough focus on inner attitudes

o  
Reduced episodes by 60 – 80%

·        
Interpersonal Psychotherapy (IPT)

o  
Slower than CBT

o  
Interpersonal functioning

o  
Too focused on emotions

·        
Dialectical Behavior Therapy

o  
Very effective

o  
Emotional turmoil

o  
Reduces symptoms

o  
Too much effort

o  
6 months single therapy

o  
6 months group therapy

o  
24-hour phone coaching

·        
Guided self-help (GSH)

o  
Few patients fully recover

o  
Less severe

o  
Used when others not possible

o  
General practitioners

o  
Decreases in symptoms

·        
Group training program

o  
Experiment

o  
Group format

o  
Normalize experiences

o  
Learn from others

o  
Explore others’ minds

o  
Patients referred by doctors

o  
Aged 18-60

o  
Had to meet criteria

o  
4 single sessions

o  
12 groups sessions

o  
1 follow – up session

o  
3 stages

o  
Eating Disorder Examination (EDE)

o  
Depression, Anxiety and Stress Scale

o  
Clinical Impairment Assessment

o  
Significant improvement

o  
Hypothesis not supported

o  
Can be alternate to CBT

o  
No difference between individual and group

·        
Family – based treatment

o  
Educate family about illness

o  
Stage 1: disrupt binge eating

o  
Stage 2: gain control over child’s eating
habits

o  
Stage 3: address effects of illness of
development of child

o  
Most effective when not limited to just
family

·        
Pharmacotherapy

o  
Antidepressants proven effective

o  
Reduce bingeing

o  
Didn’t remove all symptoms

o  
Core emotions remained

o  
Minimum advantage over CBT

·        
A-C Grading

o  
National Institute for Clinical Excellence
(NICE)

o  
C – expert consensus

o  
A – strong experiment

o  
Only CBT received grade A

·        
Other treatments

o  
Nondirective therapy

o  
Pill placebo

o  
Manualized psychodynamic therapy

o  
Stress management

 

Characteristics

·        
Binge eating

·        
Young women

·        
Poor social skills

·        
Negative self-image

·        
Fewer supportive relationships

·        
Negative methods of coping

·        
Self-criticism

·        
Approximately 8 million people

·        
External/internal shame

·        
Vomiting

·        
Drug abuse

·        
Abdominal pain

·        
Excessive exercise

·        
Abnormal

·        
Distressing

·        
Symptoms easy to hide

·        
Guilt

·        
Sense of loss of control

·        
Middle – late adolescence

·        
90% wanting treatment are women

 

Causes

·        
Severe life events

·        
Chronic difficulties

·        
Childhood experiences

·        
Affected by culture

·        
Desire to be thin

·        
High expectations from themselves

·        
Biological

o  
Family alcoholism history

o  
Depression/anxiety history

o  
Little proof

·        
Sociocultural

·        
Family

o  
Disorganized

o  
Not expressive

o  
Domineering mothers

o  
Demanding parents

o  
Compare their children

·        
Physical changed during puberty

o  
Rapid onset of weight gain

·        
Childhood mealtime experiences

 

History

·        
Western countries

·        
Urbanized areas

·        
Acknowledged by American Psychiatric
Association (1980)

·        
Gerald Russel

o  
Published paper (1979)

·        
Known as night eating syndrome

·        
Like anorexia

o  
Opposite symptoms

·        
Occurrence increased over time

Case Studies

·        
Chinese woman

o  
Culture factors

o  
23 years old

o  
Had depression after dad’s car accident

o  
Given fluoxetine

o  
Ate compulsively

o  
Hospitalized

o  
Discovered her adoption

o  
Left home

o  
Unusual symptoms

o  
No weight concerns

o  
No fat phobia

o  
Could be caused by parents’ secrets

o  
Collectivism in Chinese culture

o  
Fear of abandonment

o  
Father wanted illness to be a secret

o  
Difficult for her to accept care

·        
Childhood mealtime experiences study

o  
Explores why food is the main attractant

o  
128 females

o  
College students

o  
Bulimic Investigatory Test

o  
Childhood Family Mealtime Questionnaire

o  
Split into 3 groups

§  Bulimic

§  Repeat
dieter

§  Non-bulimic

o  
 Negative
early mealtime experiences

o  
High levels of stress

o  
Conflicts during meals

o  
Food used as rewards or punishments

o  
Beauty associated with weight

o  
Family encouraged diets

o  
Liberal method

o  
Need a longitudinal study

·        
Can lead to diabetes

o  
High blood sugar levels

o  
Not enough insulin to balance

o  
152 adolescents

o  
Aged 11-19

o  
Type 1 diabetes for at least 1 year

o  
Eating Disorders Inventory

o  
Poor control over eating habits

o  
Used to prevent future problems

 

 

 

 

 

 

 

 

 

 

 

 Treatments

·        
Cognitive
Behavior Therapy (CBT)

o  
30%
– 40% symptom free

o  
Effective
for some, not all

o  
Not enough focus on inner attitudes

o  
Reduced episodes by 60 – 80%

·        
Interpersonal Psychotherapy (IPT)

o  
Slower than CBT

o  
Interpersonal functioning

o  
Too focused on emotions

·        
Dialectical Behavior Therapy

o  
Very effective

o  
Emotional turmoil

o  
Reduces symptoms

o  
Too much effort

o  
6 months single therapy

o  
6 months group therapy

o  
24-hour phone coaching

·        
Guided self-help (GSH)

o  
Few patients fully recover

o  
Less severe

o  
Used when others not possible

o  
General practitioners

o  
Decreases in symptoms

·        
Group training program

o  
Experiment

o  
Group format

o  
Normalize experiences

o  
Learn from others

o  
Explore others’ minds

o  
Patients referred by doctors

o  
Aged 18-60

o  
Had to meet criteria

o  
4 single sessions

o  
12 groups sessions

o  
1 follow – up session

o  
3 stages

o  
Eating Disorder Examination (EDE)

o  
Depression, Anxiety and Stress Scale

o  
Clinical Impairment Assessment

o  
Significant improvement

o  
Hypothesis not supported

o  
Can be alternate to CBT

o  
No difference between individual and group

·        
Family – based treatment

o  
Educate family about illness

o  
Stage 1: disrupt binge eating

o  
Stage 2: gain control over child’s eating
habits

o  
Stage 3: address effects of illness of
development of child

o  
Most effective when not limited to just
family

·        
Pharmacotherapy

o  
Antidepressants proven effective

o  
Reduce bingeing

o  
Didn’t remove all symptoms

o  
Core emotions remained

o  
Minimum advantage over CBT

·        
A-C Grading

o  
National Institute for Clinical Excellence
(NICE)

o  
C – expert consensus

o  
A – strong experiment

o  
Only CBT received grade A

·        
Other treatments

o  
Nondirective therapy

o  
Pill placebo

o  
Manualized psychodynamic therapy

o  
Stress management

 

Characteristics

·        
Binge eating

·        
Young women

·        
Poor social skills

·        
Negative self-image

·        
Fewer supportive relationships

·        
Negative methods of coping

·        
Self-criticism

·        
Approximately 8 million people

·        
External/internal shame

·        
Vomiting

·        
Drug abuse

·        
Abdominal pain

·        
Excessive exercise

·        
Abnormal

·        
Distressing

·        
Symptoms easy to hide

·        
Guilt

·        
Sense of loss of control

·        
Middle – late adolescence

·        
90% wanting treatment are women

 

Causes

·        
Severe life events

·        
Chronic difficulties

·        
Childhood experiences

·        
Affected by culture

·        
Desire to be thin

·        
High expectations from themselves

·        
Biological

o  
Family alcoholism history

o  
Depression/anxiety history

o  
Little proof

·        
Sociocultural

·        
Family

o  
Disorganized

o  
Not expressive

o  
Domineering mothers

o  
Demanding parents

o  
Compare their children

·        
Physical changed during puberty

o  
Rapid onset of weight gain

·        
Childhood mealtime experiences

 

History

·        
Western countries

·        
Urbanized areas

·        
Acknowledged by American Psychiatric
Association (1980)

·        
Gerald Russel

o  
Published paper (1979)

·        
Known as night eating syndrome

·        
Like anorexia

o  
Opposite symptoms

·        
Occurrence increased over time

Case Studies

·        
Chinese woman

o  
Culture factors

o  
23 years old

o  
Had depression after dad’s car accident

o  
Given fluoxetine

o  
Ate compulsively

o  
Hospitalized

o  
Discovered her adoption

o  
Left home

o  
Unusual symptoms

o  
No weight concerns

o  
No fat phobia

o  
Could be caused by parents’ secrets

o  
Collectivism in Chinese culture

o  
Fear of abandonment

o  
Father wanted illness to be a secret

o  
Difficult for her to accept care

·        
Childhood mealtime experiences study

o  
Explores why food is the main attractant

o  
128 females

o  
College students

o  
Bulimic Investigatory Test

o  
Childhood Family Mealtime Questionnaire

o  
Split into 3 groups

§  Bulimic

§  Repeat
dieter

§  Non-bulimic

o  
 Negative
early mealtime experiences

o  
High levels of stress

o  
Conflicts during meals

o  
Food used as rewards or punishments

o  
Beauty associated with weight

o  
Family encouraged diets

o  
Liberal method

o  
Need a longitudinal study

·        
Can lead to diabetes

o  
High blood sugar levels

o  
Not enough insulin to balance

o  
152 adolescents

o  
Aged 11-19

o  
Type 1 diabetes for at least 1 year

o  
Eating Disorders Inventory

o  
Poor control over eating habits

o  
Used to prevent future problems