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Fallon P.,Private Practice | Fallon P.,University of Washington | Wisniewski L.,Cleveland Center for Eating Disorders | Wisniewski L.,Case Western Reserve University
International Journal of Eating Disorders | Year: 2013

Although evidence-based treatments (EBTs) exist for both bulimia nervosa and binge eating disorder, there is far less evidence underpinning the treatment of anorexia nervosa (AN). Furthermore, there is no clearly defined standardized approach to patients who have not responded to treatment over an extended period of time. Chronic eating disorder patients in particular might need long-term engagement with treatment providers offering a wide range of interventions. This case study highlights how an experienced private practitioner systematically employed a variety of EBT techniques for a patient with a severe, long-term eating disorder and its comorbidities, within a model of attachment and collaboration. The practice of utilizing a wide variety of EBT techniques in a systematic manner guided by clinical expertise and supported by a therapy relationship of collaboration and attachment may prove to be a fruitful avenue for future research. Copyright © 2013 Wiley Periodicals, Inc.

Walders-Abramson N.,University of Colorado at Denver | Nadeau K.J.,University of Colorado at Denver | Kelsey M.M.,University of Colorado at Denver | Schmiege S.J.,University of Colorado at Denver | And 4 more authors.
Childhood Obesity | Year: 2013

Background: An understanding of the relationships among obesity severity, medical co-morbidities, and psychological complications is important in the design of interventions to encourage overweight youth and families to accomplish healthy lifestyle changes. Methods: We evaluated associations among psychological status, diagnosed medical co-morbidities consistent with components of the metabolic syndrome, and BMI among 166 obese adolescents (11-18 years) referred for endocrinology consultation. We hypothesized that there would be higher levels of psychological distress among youth with more diagnosed components of the metabolic syndrome (i.e., more medical co-morbidities associated with obesity). Results: Contrary to expectation, we found that meeting criteria for extreme obesity alone was more predictive of psychological difficulties. Conclusions: The degree of obesity may be more relevant than the number of associated medical co-morbidities in impacting psychological health. It is important to recognize individual differences between patients in terms of identifying motivating goals for accomplishing weight management. © Copyright 2013, Mary Ann Liebert, Inc. 2013.

Taylor S.A.,Baylor College of Medicine | Garland B.H.,Baylor College of Medicine | Sanchez-Fournier B.E.,Baylor College of Medicine | Allen K.F.,Georgetown University | And 2 more authors.
Pediatrics | Year: 2013

OBJECTIVE: In an effort to develop more effective weight-loss interventions, this study examined the daily experiences and personal struggles of Mexican-American adolescent females with morbid obesity. METHODS: Twenty self-identified, morbidly obese Mexican-American adolescent females and their families were interviewed about their food choices, personal and family barriers to weight loss, sources of support, previous weight-loss experience, and weight-related beliefs. Qualitative responses were coded by using framework analysis. RESULTS: Four themes emerged from the adolescent and family responses: the impact of normal adolescent development, multiple sources of excess calories, the physical and emotional burden of excess weight for the adolescent, and the magnitude of the family's personal struggle with weight management. Multiple subthemes were also identified. CONCLUSIONS: Responses by the adolescents and their families highlighted the intersection of adolescence and Mexican-American culture and the daily challenges of obesity. Recommendations for providers include incorporating knowledge of adolescent development and culturally sensitive care into treatment recommendations.

Federici A.,Cleveland Center for Eating Disorders | Summerfeldt L.J.,Trent University | Harrington J.L.,University of Ottawa | McCabe R.E.,McMaster University | And 3 more authors.
Journal of Anxiety Disorders | Year: 2010

Background: Preliminary efforts to demonstrate the utility of a self-rated version of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) have been promising; however, earlier reports are based on small clinical samples. The objective of the present study was to evaluate the level of agreement between the clinician-administered Y-BOCS and a self-report version. Methods: Participants included 86 individuals with a principal diagnosis of obsessive-compulsive disorder (OCD). All participants were given the self-report version of the Y-BOCS to complete offsite and instructed to return it at a second assessment session (within a 2-week time frame), at which time a trained and experienced clinician administered the Y-BOCS interview. Results: The two versions were moderately correlated with the highest correlation observed for the Compulsions subscale. Comparison of scores for individual items revealed several inconsistencies between the two measures: level of agreement was low for resistance items, and the interview version generated higher compulsion severity ratings. Conclusions: The study provided moderate support for the convergence of the self-report and clinician-administered version of the Y-BOCS, however, important difference were detected between the two assessment methods. © 2010 Elsevier Ltd.

Middleman A.B.,Texas Childrens Hospital Center for Vaccine Awareness and Research | Middleman A.B.,Baylor College of Medicine | Short M.B.,University of Houston-Clear Lake | Doak J.S.,Cleveland Center for Eating Disorders
Vaccine | Year: 2012

Purpose: To describe both parent and student perspectives on the importance of various programmatic factors when deciding to participate in a school-located immunizations program (SLIP) for influenza vaccine. Methods: Questionnaires were distributed to middle- and high-school students and their parents; the document assessed demographic data, influenza vaccination history, and the importance of various factors in their decision to participate in a potential SLIP for influenza vaccine. Factor analysis created six primary factors of importance related to programming: (1) safety/trust; (2) outbreaks (representing imminent threat of disease, an environmental factor associated with program timing); (3) issues of site implementation; (4) public health benefits; (5) record-keeping; (6) medical/emotional support. Results: Participants included 621 students and 579 parents; 566 student/parent dyads were included. Most respondents were female, felt it is important to be immunized against the flu, and received the influenza vaccine in the past. Fewer than 50% had received the intranasal vaccine. More parents (67%) than students (46%) expressed a general willingness to consent to utilizing a SLIP. The programmatic factors associated with public health were second only to safety/trust factors as the most important to parents and students when considering participation in a SLIP. Demographic variables were found to be associated with the importance ratings of program factors associated with participation in a SLIP. Conclusions: When considering possible participation in SLIPs, parents and students consider programmatic factors associated with safety/trust and public health benefits to be of the greatest importance. Further study will be needed to develop effective and culturally sensitive messaging that targets and emphasizes these factors to potentially increase participation in SLIPS. © 2012 Elsevier Ltd.

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