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Murray S.B.,The Redleaf Practice | Wallis A.,Eating Disorder Service | Rhodes P.,University of Sydney
Contemporary Family Therapy | Year: 2012

Maudsley family based treatment (FBT) continues to demonstrate promising evidence in the treatment of adolescent presentations of anorexia nervosa. In the earlier stages of this treatment modality, the process of empowering families, and in particular, helping parent to follow their natural instincts in making united decisions around re-feeding their child is critical. This paper aims to provide FBT practitioners with structured interviewing guidelines around the amplification of familial interactions around food, drawing on existing familial strengths and therefore empowering parents and families in their process of change. The questioning skills outlined are discussed in light of the theoretical tenets of the Maudsley FBT model. © 2012 Springer Science+Business Media New York.

Eagles J.M.,Royal Cornhill Hospital | du Feu J.M.,Jersey General Hospital | Morris J.,Eden Unit | Crockett P.,Eating Disorder Service | Bhattacharya S.,University of Aberdeen
Current Psychiatry Reviews | Year: 2012

Eating disorders and infertility are both common among women in industrialized countries, and eating disorders (most notably anorexia nervosa) have long been considered to significantly reduce fertility. Especially since eating disorders are often undiagnosed, routine screening has been widely suggested when infertile women present for investigation or treatment. This paper reviews fertility of women with current, or a history of, eating disorders. There is evidence that anorexia nervosa directly impairs fertility, but the situation is less clear for milder eating disorders. Fertility and the treatment of infertility are impaired by excessive weight, so any eating disorder that is associated with obesity will contribute to infertility. While previous screening studies of infertile women have suggested that eating disorders are common, there have been very few such studies and a total of less than 250 women have been screened. The paper summarizes logical criteria for routine screening and concludes that insufficient numbers of women have been scrutinised at present to know if this would be appropriate. If prevalence were found to be high then it may be deemed necessary to demonstrate that such women could be engaged in treatment for their eating disorders and perhaps also that this had a tangible effect in improving fertility rates before a strong case for routine screening could be argued. © 2012 Bentham Science Publishers.

Urgesi C.,University of Udine | Urgesi C.,Irccs Scientific Institute E Medea | Fornasari L.,University of Udine | Canalaz F.,University of Udine | And 10 more authors.
British Journal of Psychology | Year: 2014

Patients with anorexia nervosa (AN) suffer from severe disturbances of body perception. It is unclear, however, whether such disturbances are linked to specific alterations in the processing of body configurations with respect to the local processing of body part details. Here, we compared a consecutive sample of 12 AN patients with a group of 12 age-, gender- and education-matched controls using an inversion effect paradigm requiring the visual discrimination of upright and inverted pictures of whole bodies, faces and objects. The AN patients presented selective deficits in the discrimination of upright body stimuli, which requires configural processing. Conversely, patients and controls showed comparable abilities in the discrimination of inverted bodies, which involves only detail-based processing, and in the discrimination of both upright and inverted faces and objects. Importantly, the body inversion effect negatively correlated with the persistence scores at the Temperament and Character Inventory, which evaluates increased tendency to convert a signal of punishment into a signal of reinforcement. These results suggest that the deficits of configural processing in AN patients may be associated with their obsessive worries about body appearance and to the excessive attention to details that characterizes their general perceptual style. © 2013 The British Psychological Society.

Mountford V.A.,Eating Disorder Service | Mountford V.A.,Kings College London | Brown A.,Eating Disorder Service | Bamford B.,St Georges, University of London | And 4 more authors.
European Eating Disorders Review | Year: 2015

Body image disturbance can be enduring and distressing to individuals with eating disorders and effective treatments remain limited. This pilot study evaluated a group-based treatment - BodyWise - developed for use in full and partial hospitalization with patients with anorexia nervosa at low weight. A partial crossover waitlist design was used. BodyWise (N = 50) versus treatment as usual (N = 40) were compared on standardized measures of body image disturbance. Results demonstrated significant improvement in the group compared to treatment as usual for the primary outcome measure (Eating Disorder Examination - Questionnaire Shape Concern subscale) and other manifestations of body image disturbance including body checking and body image quality of life. BodyWise appeared acceptable to participants, and was easy to deliver within the pragmatics of a busy eating disorder service. There is potential for its wider dissemination as a precursor to more active body image interventions. © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.

Sepulveda A.R.,Kings College London | Todd G.,Eating Disorder Service | Whitaker W.,Eating Disorder Service | Grover M.,Eating Disorder Service | And 2 more authors.
International Journal of Eating Disorders | Year: 2010

Objective: The first aim of this work was to examine whether high expressed emotion (EE) would be associated with psychological distress and negative appraisal of caregiving. The second aim was to examine whether could replicate the findings of (Uehara et al., Compr Psychiatr, 42, 132-138, 2001) regarding a reduction in EE in association with a psycho-educational intervention. Method: A prospective exploratory follow-up assessment of 47 caregivers in which EE was measured by Five Minutes Speech Sample, Experience of Caregiving Inventory and General Health Questionnaire (GHQ-12). Results: High EE ratings were found in 26/47 (55%) carers at baseline. The high EE group had a higher negative aspects of caregiving (high EE = 109.8 vs. low EE = 93.7, p = 0.04). The number of carers with high-EE fell from 55% to 24% after intervention, and remained below at follow-up. The levels of distress and caregiving burden of the caregivers were also reduced. Discussion: Fifty-five percent of the caregivers have high EE. High-EE relatives noted a higher caregiving burden than low-EE relatives particularly on the 'dimension of loss'. The level of EE was reduced following a skills training program. © 2009 by Wiley Periodicals, Inc.

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