摘要:

AbstractThis article summarizes current understanding of the pathophysiology of anorexia nervosa. Evidence is reviewed of alterations in hypothalamic‐pitui‐tary‐thyroid mechanisms, catecholamine metabolism, and endogenous opioid activity. It is concluded that once weight loss and starvation occur, the usual mechanisms for release and inhibition of various regulators of eating behavior change, and a new set of regulating mechanisms is instituted. Thus, despite an increased body of knowledge, understanding of the origins of anorexia nervosa still elud

ISSN:0276-3478    

DOI:10.1002/1098-108X(198511)4:4<347::AID-EAT2260040402>3.0.CO;2-K

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1985

数据来源: WILEY

ISSN:0276-3478    

DOI:10.1002/1098-108X(198511)4:4<389::AID-EAT2260040403>3.0.CO;2-3

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1985

数据来源: WILEY

摘要:

AbstractOne of the most controversial dimensions along which developing therapeutic approaches for bulimia can be differentiated is their allegiance to an “abstinence” or “nonabstinence” model. Through analogy to traditional treatment programs for chemical dependency, many self‐help and professional programs for bulimia hold that the complete elimination of binge‐vomiting behavior is a prerequisite for therapeutic work, and require abstinence from the inception of treatment. In contrast, the nonabstinence model suggests that a more gradual reduction in the frequency of episodes may be preferable in that it provides more opportunities for relapse prevention training and avoids reinforcing dichotomous thinking styles. The present paper reviews the theoretical and clinical arguments that have been advanced by each side, including the case for classifying bulimia as a substance abuse disorder. A strategy for investigating the relative efficacy of the two approaches is proposed. It is suggested that particular attention be paid to such variables as differential attrition, the effect of each modality on the accuracy of self‐report, the need for continuing or supplementary therapy, the occurrence of treatment “casualties,” interactions between client characteristics and mode of therapy, and long‐term results. In the interim before such data are available, a reasonable clinical recommendation may be the implementation of a “compromise” approach designed to maximize the advantages claimed by each model while mi

ISSN:0276-3478    

DOI:10.1002/1098-108X(198511)4:4<407::AID-EAT2260040404>3.0.CO;2-P

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1985

数据来源: WILEY

摘要:

AbstractA video camera technique was used to assess perceived actual and ideal size in patients with a restricting type of anorexia nervosa (n = 17), bulimia nervosa patients with previous anorexia (n = 23), bulimia nervosa patients with no previous anorexia (n = 24), phobic controls (n = 18), and normals (n = 33). Bulimic patients with previous anorexia demonstrated a significantly greater tendency to overestimate their actual body size (p<.05) than subjects in the restricting anorexic or control groups. Previously anorexic bulimics also demonstrated more overall clinical and personality disturbance than any of the other groups (p<.01). Body size overestimation and dissatisfaction were strongly associated with the duration and severity of the eating disturbance in previously anorexic bulimics but there were no clear relationships between clinical or personality disturbances and body size distortions in the restricting anorexic or never‐anorexic bulimic groups. Results are discussed with respect to the importance of refining diagnostic criteria for subtypes of anorexia and bulimia nervosa. Multitrait‐multimethod methodologies are recommended for purposes of elucidating “body image disturbance” and its importance in the etiology and maintenance of eating di

ISSN:0276-3478    

DOI:10.1002/1098-108X(198511)4:4<439::AID-EAT2260040405>3.0.CO;2-B

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1985

数据来源: WILEY

摘要:

AbstractThirty bulimic patients who had gained control of their eating behavior for a minimum of 2 months but had subsequently relapsed were identified. These patients represented a subsample of a series of 75 patients who had been evaluated in an outpatient eating disorders clinic and followed up at 12 to 75 months. More than one‐half of those who relapsed did so within two months of finishing treatment and one‐third relapsed while still involved in aftercare therapy. Variables associated with relapse included stressful or difficult situations and feeling anxious, nervous, or depressed. The implications for treatment of these findings are discus

ISSN:0276-3478    

DOI:10.1002/1098-108X(198511)4:4<457::AID-EAT2260040406>3.0.CO;2-4

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1985

数据来源: WILEY

摘要:

AbstractFifty‐five white and eleven black female dancers in nine regional and national ballet companies in America and Europe (mean age 24.9) were surveyed for eating disorders. The dancers, as a whole, weighed 12% below their ideal weight for height. None of the black American dancers reported anorexia nervosa or bulimia, while 15% of the white American dancers reported anorexia nervosa and 19% reported bulimia. All instances of anorexia nervosa were in national rather than regional companies, making the incidence among whites in the former 22%. Self‐reported anorectics scored higher on the EAT‐26, had lower weights, exhibited more psychopathology, and a poorer body image than the nonanorectics. In addition, all but one of the self‐reported anorectics weighed, or had weighed, less than 20% of ideal weight for height. The bulimics valued their careers less, dieted more, and exercised less frequently than the nonbulimics. Weight did not differ for these two groups. The data suggest that the anorectic dancers differ from dancers with no eating disorders and that sociocultural factors are related to the report of eating disorders. Specifically, level of competition is related to reported anorexia nervosa and ethnicity to anorexia nervosa and

ISSN:0276-3478    

DOI:10.1002/1098-108X(198511)4:4<465::AID-EAT2260040407>3.0.CO;2-0

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1985

数据来源: WILEY

摘要:

AbstractEight black and 120 white patients with anorexia nervosa or bulimia were compared with each other and with 21 black control patients. Biack and white patients with eating disorders were similar in demographic features (except for later age of onset in blacks), in clinical characteristics, and in course of illness. Both racial groups with eating disorders had a significantly higher socioeconomic status than control patients. A diagnosis of anorexia nervosa or bulimia can be confidently made independent of racial designation. Socioeconomic status appears to be a risk factor for development of anorexia nervosa or bulimia in both black and white populations.

ISSN:0276-3478    

DOI:10.1002/1098-108X(198511)4:4<479::AID-EAT2260040408>3.0.CO;2-R

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1985

数据来源: WILEY

摘要:

AbstractEating Attitudes Test (EAT) scores gathered from 18 female adolescent anorectic patients with very early onset of the disease were compared with existing literature, and analyzed in terms of their relationships to clinical and background variables and other scales measuring anorectic behavior. Trans‐cultural comparisons revealed that this sample of German patients had lower scores than Canadian, British, and Dutch samples of older age. The scores of the EAT were independent of denial of illness. Vomiters and lower‐class patients had fewer abnormal scores. Therapeutic change between admission and discharge from inpatient treatment was reflected in improved EAT scores. A number of significant correlations with other scales measuring anorectic behavior were detec

ISSN:0276-3478    

DOI:10.1002/1098-108X(198511)4:4<489::AID-EAT2260040409>3.0.CO;2-L

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1985

数据来源: WILEY

摘要:

AbstractThirteen patients with anorexia nervosa, aged 16–23 years (2 males and 11 females), were studied during the first week after hospital admission at an average weight of 65.4±6.2% of ideal body weight (IBW), again after a weight increase of 10%, and before discharge. The patients gained weight in a broad spectrum behavior therapy program. Serial blood samples were obtained during the morning hours. Growth hormone was greatly elevated in about half of the patients during the first study. After 10% weight gain, values were normalized and stayed unchanged thereafter. Trijodthyronine values were low in the beginning. The values were significantly increased at the second assessment but continued to rise thereafter. Noradrenaline concentrations in plasma were normal at the first assessment, as well as in both a supine and in an erect body position. After 10% weight gain, resting levels were significantly decreased and the increase while standing was impaired. At the last assessment, at an average body weight of 80.9± 7% IBW, noradrenaline levels were greater than at the second assessment, but not yet normalized. Plasma prolactin remained unchanged during the entire st

ISSN:0276-3478    

DOI:10.1002/1098-108X(198511)4:4<499::AID-EAT2260040410>3.0.CO;2-7

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1985

数据来源: WILEY

摘要:

AbstractIn the present study, equal numbers of patients with anorexia nervosa and bulimiawere compared with noneating‐disordered control subjects on the Block Ego Control Scale, Adjective Check List Autonomy Scale, and Embedded Figures Test. The anorexics displayed significantly greater ridigity of control than the noneating‐disordered subjects, whereas the bulimics could not be distinguished from either of the other two groups on this dimension. Although there were no group differences in self‐ascribed level of autonomy, both eating‐disordered groups were significantly more field dependent than the control group, suggesting a diminished capacity for autonomous functioning in patients with these disorders. The results are seen as supporting Bruch's thesis that anorexics manifest a rigid overcontrolling ego style as a compensation for a deficit in self‐directed autonomy. Bulimic patients appear to experience a similar deficit in their capacity for autonomous functioning, although their mode of monitoring impulse may be more

ISSN:0276-3478    

DOI:10.1002/1098-108X(198511)4:4<511::AID-EAT2260040411>3.0.CO;2-Z

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1985

数据来源: WILEY