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- Birgegard, A, et al.
(författare)
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Self-image and risk of suicide in eating disorders
- 2017
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Ingår i: EUROPEAN PSYCHIATRY. - : Cambridge University Press (CUP). - 0924-9338 .- 1778-3585. ; 41, s. S281-S281
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Suicide risk is increased in eating disorders (ED), and detection is key to prevention. Self-image as operationalized in the structural analysis of social behavior (SASB) model has been shown to be associated with symptoms, treatment dropout, and outcome. SASB is a circumplex organizing self-directed behaviors along affiliation (love vs. hate) and autonomy (set free vs. control) dimensions. In a recent study, SASB related to health care-detected suicide attempts in ED. Methodology in that study ensured high specificity but risked lower sensitivity in suicide variables, and with such a high-threat outcome, research is needed on additional variables related to risk.Objectives and aimsWe aimed to study associations between SASB self-image and clinician- and self-rated suicidality at presentation and predicted over 12 months in ED patients.MethodsAdult patients (n = 551) from a Swedish clinical database included 19% anorexia, 32% bulimia, 7% binge ED, and 42% other ED. We ran separate regression models for these diagnostic groups using SASB questionnaire data, also controlling for general psychiatric and ED symptoms, and in longitudinal models including baseline of each outcome.ResultsSASB alone was associated with suicidality at presentation (9–67% variance explained) and predictively over 12 months (7–29%), and in the majority of models explained additional variance beyond baseline and clinical variables. Both affiliation and autonomy related to dependent variables in diagnosis-specific patterns.ConclusionsThe findings have implications for both theory and detection tools for suicide risk, as well as suggesting intervention targets to mitigate risk in treatment based on the well-validated SASB theory.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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- Forsén Mantilla, Emma, et al.
(författare)
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Insidious: The relationship between patients and their eating disorders and its impact on ED symptoms, illness duration and self-image
- 2017
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Ingår i: EUROPEAN PSYCHIATRY. - : Cambridge University Press (CUP). - 0924-9338 .- 1778-3585. ; 41, s. S552-S552
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Patients with eating disorders (EDs) often spontaneously talk about their disorder in terms of a symbolic other (a demon, a voice, a guardian). Further, externalizing exercises where patients are encouraged to separate their true self from their ED self are common in some treatment approaches. Yet, no previous quantitative study has investigated this phenomenon. We examined the patient-ED relationship (using the interpersonal structural analysis of social behavior methodology) and its implications for ED symptoms, illness duration and self-image. Participants were 16–25 year old female patients (N = 150) diagnosed with anorexia nervosa (N = 55), bulimia nervosa (N = 33) or eating disorder not otherwise specified (N = 62). Results suggested that patients had comprehensible and organized relationships with their EDs. EDs were primarily experienced as acting critical and controlling towards patients. Higher ED control was associated with more ED symptoms and longer illness duration, especially when coupled with patient submission. Patients reacting more negatively towards their EDs than their EDs were acting towards them had lower symptom levels and more positive self-images. Externalizing one's ED, relating to it like a symbolic other, seemed to make sense to patients and depending on its quality seemed to influence ED symptoms, illness duration and self-image. We put forward both clinical and theoretical implications based on the assumption that the patient-ED relationship may function in similar ways as real-life interpersonal relationships do.The authors have not supplied their declaration of competing interest.
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- Levallius, J, et al.
(författare)
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Run for it: Compulsive exercise in adolescents with eating disorders - a nationwide longitudinal study
- 2017
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Ingår i: EUROPEAN PSYCHIATRY. - : Cambridge University Press (CUP). - 0924-9338 .- 1778-3585. ; 41, s. S555-S556
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Rigorous exercise to control weight and/or shape and to avoid negative affect has been proposed as significant in the etiology, development and maintenance of eating disorders (EDs), resulting in more severe and enduring pathology. However, few studies have investigated compulsive exercise (CE) among adolescents with EDs.ObjectiveTo study the longitudinal relationship between EDs and CE in adolescents.Aims to investigate if adolescent ED patients show a similar relation between EDs and CE as previous research has found in adults.MethodsA total of 3116 girls and 139 boys from a nationwide clinical EDs database were investigated on CE prevalence and frequency in relation to ED diagnosis, psychiatric symptoms, associated features and outcome. Denial of illness in self-ratings was adjusted for.ResultsAdjusted CE prevalence in girls was 44%; with highest prevalence in bulimia nervosa. Average CE frequency was 3.9 times/week (SD = 2.6). Those with CE scored significantly higher than non-CE on total ED severity, dietary restriction and negative perfectionism (P < 0.001). There were only minor differences between CE and non-CE patients on emotional distress, hyperactivity, suicidality and self-esteem. Among boys, adjusted CE prevalence was 38%, and only total ED severity was significantly related to CE (P < 0.05). Initial CE did not impact prognosis, yet cessation of CE during 1-year follow-up was associated with ED remission.ConclusionsCE is a common clinical feature in adolescents with EDs, as previously found in adults. CE had less detrimental impact on EDs than predicted and cessation was associated with better outcome.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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