Clinical Handbook of Eating Disorders: An Integrated Approach (Medical Psychiatry, 26)

Book Cover......Page 1
Half-Title......Page 2
Title......Page 6
Copyright......Page 7
Dedication......Page 8
Foreword......Page 9
Preface......Page 13
Contents......Page 19
Contributors......Page 22
Anorexia Nervosa......Page 26
Bulimia Nervosa......Page 29
Binge Eating Disorder......Page 32
COMMON DIFFERENTIAL DIAGNOSES IN EATING DISORDERS IN ADULTS......Page 35
The Very Young......Page 36
EFFECTS OF CULTURE ON THE DIAGNOSIS OF ANOREXIA NERVOSA......Page 37
EFFECT OF GENETIC CAUSALITY ON DIAGNOSIS IN EATING DISORDERS......Page 38
APPENDIX 1 Sample Clinical Interview Format......Page 40
REFERENCES......Page 42
2 Psychometric Assessment of Eating Disorders......Page 44
Structured Interviews......Page 45
Yale-Brown-Cornell Eating Disorder Scale (YBC-EDS; 12)......Page 46
Eating Attitudes Test (EAT; 25,26)......Page 47
Eating Disorder Inventory (EDI; 38)......Page 48
Revised Bulimia Test (BULIT-R; 45)......Page 49
Mlzes Anorectic Cognitions Scale (MACS-R; 55)......Page 50
Motivation to Change......Page 51
Anorexia Nervosa Stage of Change Questionnaire (ANSOCQ; 66)......Page 52
GENERAL PSYCHOPATHOLOGY......Page 53
Yale-Brown Obsessive Compulsive Scale (Y-BOCS; 76,77)......Page 54
Beck Depression Inventory, Second Edition (BDI-II; 87)......Page 55
Beck Anxiety Inventory (BAI; 91)......Page 56
Michigan Alcoholism Screening Test (MAST; 104)......Page 57
Brief Symptom Inventory (BSI; 121)......Page 58
Inventory of Interpersonal Problems (IIP; 127)......Page 59
Family Environment Scale (FES; 136)......Page 60
SUMMARY AND RECOMMENDATIONS......Page 61
REFERENCES......Page 62
Pica......Page 72
Rumination......Page 73
Feeding Disorder of Infancy and Early Childhood......Page 74
Feeding Disorders Presenting to Clinical Services......Page 76
FROM FEEDING TO EATING DISORDERS: ISSUES OF CONTROL AND SELF-REGULATION......Page 81
ASSESSMENT OF FEEDING PROBLEMS......Page 85
History and Development of the Feeding Problem......Page 86
Assessment of Systemic Context......Page 87
Behavioral and Emotional Assessment......Page 88
MANAGEMENT OF FEEDING PROBLEMS......Page 89
OUTCOME......Page 90
REFERENCES......Page 91
4 Epidemiology of Eating Disorders and Disordered Eating: A Deveiopmental Overview......Page 96
Classification......Page 97
Disordered Eating......Page 98
Prevalence......Page 101
Age and Sex......Page 103
Prevalence......Page 105
Incidence......Page 107
Time Trends......Page 108
Binge Eating Disorder......Page 109
Social Class......Page 110
Level of Industrialization......Page 111
Occupation......Page 112
COMMENTS......Page 113
REFERENCES......Page 115
5 Long-Term Outcome, Course of Illness and Mortality in Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder......Page 122
Recovery......Page 123
Prognostic Factors......Page 124
Treatment Utilization......Page 125
Recovery......Page 126
Prognostic Factors......Page 127
Treatment Utilization......Page 128
Anorexia Nervosa and Bulimia Nervosa......Page 129
CONCLUSIONS......Page 133
REFERENCES......Page 134
6 An Overview of Risk Factors for Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder......Page 142
OVERVIEW OF BASIC RISK FACTOR CONCEPTS......Page 144
METHOD......Page 145
CHARACTERISTICS OF LONGITUDINAL RISK FACTOR STUDIES FOR EATING DISORDERS......Page 147
Age......Page 150
General Psychiatric Disturbance/Negative Emotionality......Page 151
Adverse Life Events......Page 153
Early Childhood Eating and Digestive Problems......Page 154
Family Interaction/Family Functioning/Attachment Styles......Page 155
Family History/Family Psychopathology......Page 156
Low Self-Esteem/Negative Self-Concept/lneffectiveness......Page 157
Athletic Competition/Participation in Weight-Related Subculture/Exercise......Page 158
Other Factors......Page 159
CNS Serotonin Activity......Page 160
Pubertal Timing......Page 162
Weight Concerns/Dieting/Negative Body Image......Page 163
General Psychiatric Disturbance/Negative Emotionality......Page 164
Sexual Abuse......Page 166
BMI and Other Weight-Related Variables......Page 167
Family Interaction/Family Functioning/Attachment Styles......Page 168
Low Self-Esteem/Negative Self-Concept/lneffectiveness......Page 169
Perfectionism......Page 170
Athletic Competition/Participation in Weight-Related Subculture/Exercise......Page 171
CNS Serotonin Activity......Page 172
Pregnancy and Perinatal Complications......Page 173
Psychosocial Factors......Page 174
ADDITIONAL RISK FACTOR CHARACTERISTICS......Page 176
SUMMARY AND CONCLUSIONS......Page 177
REFERENCES......Page 179
THE BURDEN OF PLAUSIBILITY......Page 190
Twin Studies......Page 191
What Is Heritability? What Isn’t Heritability?......Page 193
Family Studies of Eating Disorders......Page 194
The Equal Environment Assumption......Page 195
Twin Studles of Anorexia Nervosa......Page 196
Twin Studies of Bulimia Nervosa......Page 197
Twin Studies of Binge Eating Disorder......Page 198
USING TWIN STUDIES TO EXPLORE THE RELATION BETWEEN ANOREXIA AND BULIMIA NERVOSA......Page 199
WHY DO WE NOT DETECT COMMON ENVIRONMENTAL EFFECTS IN TWIN STUDIES OF EATING DISORDERS?......Page 200
IMPLICATIONS OF FAMILY AND TWIN FOR PREVENTION AND CLINICAL PRACTICE......Page 202
CONCLUSIONS......Page 203
REFERENCES......Page 204
OVERVIEW......Page 208
Anorexia Nervosa......Page 210
Binge Eating Disorder......Page 211
PSYCHIATRIC COMORBIDITY......Page 212
Mood Disorders......Page 213
Anxiety Disorders......Page 216
Substance Use Disorders......Page 219
Impulse Control Disorders......Page 221
Dissociative Disorders......Page 222
ADHD and Disruptive Behavior Disorders of Childhood......Page 223
SUMMARY......Page 224
REFERENCES......Page 225
EATING AND PERSONALITY PATHOLOGIES......Page 234
State-Trait Debate......Page 238
Personality Traits in the EDs......Page 235
Specific Traits......Page 236
Personaiity Disorders in the EDs......Page 237
Family/Developmental Characteristics......Page 239
Childhood Abuse......Page 240
Neurobiology of Eating and Personality Disturbances......Page 241
Symptoms......Page 242
Anorexia Nervosa......Page 243
Bulimia Nervosa......Page 244
WITHIN-SUBTYPE HETEROGENEITY AS TO PERSONALITY FEATURES......Page 245
INTEGRATION AND CLINICAL APPLICATIONS......Page 246
CONCLUSIONS......Page 249
REFERENCES......Page 250
10 Medical Comorbidity of Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder......Page 258
ASSESSMENT......Page 259
Cardiac Complications......Page 261
Renal Complications......Page 263
Endocrine Abnormalities......Page 264
Gastrointestinal Complications......Page 267
Central Nervous System Complications......Page 269
Musculoskeletal Complications......Page 271
Gynecological and Obstetrical Complications......Page 273
REFERENCES......Page 275
11 Neurotransmitter Dysregulation in Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder......Page 282
MONOAMINES......Page 283
NOREPINEPHRINE......Page 284
DOPAMINE......Page 286
SEROTONIN......Page 287
Possible Trait-Linked Effects......Page 290
Evidence from Pharmacological Effects......Page 293
CONCLUSIONS......Page 294
REFERENCES......Page 295
NEUROENDOCRINOLOGY......Page 308
NEUROPEPTIDES......Page 310
Vasopressin and Oxytocin......Page 311
Neuropeptide Y and Peptide YY......Page 312
Leptin......Page 313
Ghrelin......Page 314
CONCLUSIONS AND PERSPECTIVES......Page 315
REFERENCES......Page 316
GENERAL ASPECTS OF METHODOLOGY......Page 322
BACKGROUND: BRAIN DEVELOPMENT......Page 323
BRAIN STRUCTURE AND EATING DISORDERS......Page 324
BRAIN FUNCTION IN EATING DISORDERS......Page 325
Animal Models......Page 326
Hunger and Satiety......Page 328
Food Challenges in Eating Disorders......Page 331
NEUROTRANSMISSION......Page 333
WHAT CAN WE UNDERSTAND FROM THE FUNCTIONAL STUDIES?......Page 335
The Lateral Prefrontal Cortex......Page 336
Anorexia Nervosa as a Neurodevelopmental Disorder......Page 337
CONCLUSION......Page 338
SUMMARY......Page 339
REFERENCES......Page 340
14 Molecular Biology of Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, and Obesity......Page 348
GENETICS......Page 349
IDENTIFYING GENES......Page 350
SEROTONINERGIC GENES IN EATING DISORDERS......Page 352
5-HT2A Subclass......Page 353
5-HT, Subclass......Page 358
Serotonin Transporter......Page 359
Estrogen Receptors......Page 360
Catechol-O-Methyltransferase......Page 363
hSKCa3......Page 364
LINKAGE ANALYSIS IN EATING DISORDERS......Page 365
OBESITY......Page 366
REFERENCES......Page 367
15 Management of Eating Disorders: Inpatient and Partial Hospital Programs......Page 374
INPATIENT TREATMENT......Page 376
PROGRAM SCHEDULING......Page 382
Psychoeducational Group......Page 388
Cognitive Group Therapy......Page 389
Body Perception Group......Page 390
Family Therapy......Page 391
Role of Medications in Treatment......Page 392
THE DISCHARGE PROCESS......Page 393
PARTIAL HOSPITALIZATION/DAY TREATMENT......Page 394
Involuntary Patients......Page 397
REFERENCES......Page 398
NUTRITIONAL COUNSELING APPROACHES......Page 404
Nutritional Assessment......Page 405
Nutritional Rehabilitation......Page 406
Weight Restoration Regimens......Page 407
Meal Plans......Page 409
Ongoing Treatment......Page 412
Family Involvement......Page 413
Nutritional Rehabilitation......Page 415
Nutrition Education and Counseling......Page 417
Ideas for Support of the Meal Plan......Page 418
Nutritional Assessment......Page 420
Nutrition Intervention and Education......Page 421
SUMMARY OF NUTRITIONAL TREATMENT GOALS FOR ANOREXIA NERVOSA, BULIMIA NERVOSA, AND BINGE EATING DISORDER......Page 423
REFERENCES......Page 424
COGNITIVE BEHAVIORAL THERAPY IN THE MANAGEMENT OF BULIMIA NERVOSA......Page 430
COGNITIVE BEHAVIORAL THERAPY IN THE TREATMENT OF BULIMIA NERVOSA......Page 431
COGNITIVE BEHAVIORAL THERAPY IN THE MANAGEMENT OF ANOREXIA NERVOSA......Page 432
GUIDELINES FOR COGNITIVE BEHAVIORAL TREATMENT OF THE EATING DISORDERS......Page 436
Initiating CBT......Page 437
Cues and Consequences......Page 438
Cognitive Restructuring......Page 439
Problem Solving and Social Skills Training......Page 442
Case Study......Page 443
REFERENCES......Page 448
BASIC CONCEPTS AND PRINCIPLES OF FAMILY THERAPY......Page 452
HISTORY OF FAMILY THERAPY IN TREATMENT OF EATING DISORDERS......Page 453
FAMILY CHARACTERISTICS OF INDIVIDUALS WITH AN EATING DISORDER......Page 454
FAMILY EVALUATION......Page 456
FAMILY THERAPY IN THE TREATMENT OF ANOREXIA NERVOSA......Page 458
FAMILY THERAPY IN THE TREATMENT OF BULIMIA NERVOSA......Page 463
BINGE EATING DISORDER......Page 466
FAMILY THERAPY IN CLINICAL PRACTICE......Page 467
SUMMARY......Page 470
REFERENCES......Page 471
THEORETICAL FOUNDATIONS OF INTERPERSONAL PSYCHOTHERAPY......Page 476
INTERPERSONAL PSYCHOTHERAPY FOR EATING DISORDERS......Page 477
Interpersonal Problem Areas......Page 478
Tasks of the Treatment Phases (Table 2)......Page 481
General Therapeutic Techniques......Page 489
Interpersonal Psychotherapy for Bulimia Nervosa......Page 491
Interpersonal Psychotherapy for Anorexia Nervosa......Page 492
SUMMARY AND FUTURE DIRECTIONS......Page 493
REFERENCES......Page 494
20 Use of Dialectical Behavior Therapy in the Eating Disorders......Page 500
PHILOSOPHY AND ASSUMPTIONS OF DIALECTICAL BEHAVIOR THERAPY......Page 501
ETIOLOGY OF BORDERLINE PERSONALITY DISORDER......Page 502
DIALECTICAL BEHAVIOR THERAPY......Page 503
MODES OF TREATMENT IN DIALECTICAL BEHAVIOR THERAPY......Page 504
Commitment Strategies in Dialectical Behavior Therapy......Page 505
Individual Therapy in Dialectical Behavior Therapy......Page 506
Dialectical Behavior Therapy Skills......Page 509
The Dialectical Behavior Therapy Consultation Team......Page 511
DIALECTICAL BEHAVIOR THERAPY EFFICACY......Page 512
DIALECTICAL BEHAVIOR THERAPY ACROSS THE EATING DISORDERS CONTINUUM OF CARE......Page 513
SUMMARY......Page 514
REFERENCES......Page 515
21 Psychopharmacology of Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder......Page 516
Antidepressants......Page 517
Antipsychotics......Page 519
Other Agents......Page 520
Antidepressants......Page 522
Other Agents......Page 524
Combination Treatment......Page 525
Antidepressants......Page 527
Anorexia Nervosa......Page 528
REFERENCES......Page 529
22 Eating Disorders, Victimization, and Comorbidity: Principles of Treatment......Page 536
RELATIONSHIP OF EATING DISORDERS TO TRAUMA HISTORY AND PTSD......Page 538
RELATIONSHIP OF COMORBID DISORDERS TO TRAUMA HISTORY AND PTSD......Page 542
Anxiety Disorders......Page 543
Substance Use Disorders......Page 544
Somatoform Disorders......Page 545
Impulse Control Disorders......Page 546
Axis II Comorbidity......Page 547
Course and Outcome......Page 548
PRINCIPLES OF TREATMENT FOR THE COMORBID ED PATIENT WITH VICTIMIZATION......Page 549
REFERENCES......Page 561
23 Future Directions in the Management of Eating Disorders......Page 574
THE FUTURE OF EATING DISORDERS DIAGNOSIS......Page 575
THE FUTURE OF EATING DISORDERS EPIDEMIOLOGY......Page 577
MOLECULAR GENETIC RESEARCH IN EATING DISORDERS: FUTURE IMPLICATION FOR TREATMENT......Page 579
OTHER FUTURE BIOLOGICAL INVESTIGATIONS IN EATING DISORDERS......Page 580
THE FUTURE OF BIOLOGICAL INTERVENTIONS FOR EATING DISORDERS......Page 581
Psychotherapies......Page 582
Individuals, Families and Friends, and Self-Help On-Line......Page 583
Health Professionals as Facilitators, Partners, and Authorities......Page 585
Adjunctive Use of e-Mail in Ambulatory Treatment of Eating Disorder Patients......Page 587
Emerging Technologies......Page 588
FUTURE SYSTEMS OF CARE FOR EATING DISORDERS......Page 589
REFERENCES......Page 590
Index......Page 596