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- Björck, Caroline, et al.
(författare)
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Self-image and treatment drop-out in eating disorders
- 2008
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Ingår i: Psychology and Psychotherapy. - Leicester, UK : British Psychological Society. - 1476-0835 .- 2044-8341. ; 81:1, s. 95-104
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Drop-out from treatment is a serious problem in eating disorders which remains poorly understood. The present study investigated whether self-image and interpersonal theory could help to explain why eating disorder patients drop out of treatment. Method: Intake data on eating disorder patients who terminated treatment prematurely (N=54) were compared with patients who had completed treatment (N=54) and those who were still in treatment after 12 months (N=54). Self-image was assessed using the structural analysis of social behaviour (SASB), and comparisons were made on demographic and clinical variables. Results: Patients who dropped out had initially presented with less negative self-image and fewer psychological problems compared with remainers. Low levels of SASB self-blame discriminated drop-outs from completers and remainers and significantly predicted treatment drop-out. Discussion: Drop-out in eating disorders appears to be a complex phenomenon, not necessarily as pathological as often assumed. There may be important differences in the treatment goals of drop-outs and therapists; patients who drop out may be choosing to disengage at a time when symptom improvement creates space for closer examination of interpersonal issues.
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| 4. |
- Björk, Tabita, 1966-, et al.
(författare)
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Criminal recidivism and mortality among patients discharged from a forensic medium secure hospital
- 2012
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Ingår i: Nordic Journal of Psychiatry. - London, United Kingdom : Informa Healthcare. - 0803-9488 .- 1502-4725. ; 66:4, s. 283-9
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Tidskriftsartikel (refereegranskat)abstract
- Background: One of the goals in forensic psychiatric care is to reduce the risk of recidivism, but current knowledge about the general outcome of forensic psychiatric treatment is limited.Aims: To analyse the rate of criminal recidivism and mortality after discharge in a sample of patients sentenced to forensic psychiatric treatment in a Swedish county.Methods: All offenders in Örebro County, Sweden, sentenced to forensic psychiatric treatment and discharged during 1992-2007 were included: 80 males and eight females. Follow-up data was retrieved from the Swedish National Council for Crime Prevention, the National Cause-of-Death register and clinical files. Mean follow-up time was 9.4 years.Results: The mean age at discharge was 40 years. Schizophrenia, other psychoses and personality disorders were the most prevalent diagnoses. Thirty-eight percent of those still alive and still living in the country re-offended and were sentenced to a new period of forensic psychiatric treatment or incarceration during follow-up. Four male re-offenders committed serious violent crimes. Substance-related diagnosis was significantly associated with risk of recidivism and after adjustment for diagnoses, age and history of serious violent crime, the Hazard Ratio was 4.04 (95% CI 1.51-10.86, P = 0.006). Of all included patients, 23% had died at the end of follow-up (standardized mortality rate 10.4).Conclusions: Since repetition of serious violent crimes was unusual, results indicate a positive development subsequent to treatment for those alive at follow-up.Clinical implications: The high mortality rate suggests that more attention should be paid in evaluation of the patients' somatic and psychiatric health during and after care in order to prevent premature death.
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| 6. |
- Björk, Tabita, et al.
(författare)
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Eating disorders and anabolic androgenic steroids in males : similarities and differences in self-image and psychiatric symptoms
- 2013
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Ingår i: Substance Abuse Treatment, Prevention, and Policy. - 1747-597X. ; 8:30, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- Background: Body dissatisfaction is common among both females and males. Dissatisfaction with the body is a risk factor both for onset of eating disorders and for abuse of anabolic androgenic steroids (AAS). Few studies have however investigated if there are other similarities in respect to self-image or psychiatric symptoms between clinical samples of eating disordered males and males in treatment for negative effects of AAS use.Aim: The aim of this study was to compare two clinical samples, one of males with ED and one of males who used AAS, regarding self-image and psychiatric symptoms.Methods: This study compared males with eating disorders (n = 13) and males who recently stopped AAS use (n = 29) on self-image and psychiatric symptoms, using The Structural Analysis of Social Behavior self-questionnaire and a shortened version of The Symptom Check List.Results: The eating disorder group reported significantly lower scores for Self-emancipation and Active self-love and higher scores for Self-blame and Self-hate. Both groups reported serious psychiatric symptoms. The common denominator between groups was serious psychiatric symptomatology rather than negative self-image.Conclusions: The negative self-image profile, especially self-hate, found among males with Eating Disorders may indicate that the studied groups differ in aetiology of the underlying problems. The serious psychiatric symptoms in both groups call staff to pay attention to any thoughts of suicide due to severe depressive symptoms where by specialized psychiatric treatment may be needed.
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| 8. |
- Björk, Tabita, 1966-, et al.
(författare)
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Laterality, hand control and scholastic performance : a British birth cohort study
- 2012
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Ingår i: BMJ Open. - London, United Kingdom : BMJ. - 2044-6055. ; 2:2, s. e000314-
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To use simple measures of laterality and hand control that can identify a greater risk of poorer scholastic ability, potentially signalling suboptimal hemispheric lateralisation.Design: Analysis of material from a birth cohort study.Setting: Members of the National Child Development Study, a British birth cohort study following people born in 1958.Participants: 10 612 children who undertook tests at age 11 years.Primary outcome measures: Teacher-administered tests of non-verbal general ability, verbal general ability, reading comprehension and mathematics. Results Linear regression produced associations (and 95% CIs) with tests of verbal general ability, non-verbal general ability, reading comprehension and mathematics scores for the lowest third (compared with highest) of a left-hand control test involving picking up matches of −1.21 (−1.73 to −0.68; p<0.001), −0.72 (−1.14 to −0.29; p=0.001), −0.70 (−1.06 to −0.35; p<0.001) and −1.32 (−1.90 to −0.73; p<0.001). Among those in the lowest third of the right-hand control test score, mixed-handedness compared with right-handedness was associated with poorer scholastic performance, with regression coefficients (and 95% CIs; p values) of 1.90 (−3.01 to −0.80; p=0.001), −1.25 (−2.15 to −0.35; p=0.007), −1.28 (2.04 to −0.53; p=0.001) and −1.33 (−2.53 to −0.13; p=0.030). The estimates are for a point change in the scholastic test scores, after adjustment for sex, left-hand motor function and social class. Statistically significant associations with mixed-handedness were only observed for the lowest third of right-hand motor function.Conclusions Measures involving poorer left-hand motor function may represent useful markers of reduced cognitive function possibly reflecting suboptimal hemispheric lateralisation. Crude measures of laterality such as reported non-right-handedness may be more useful for research when combined with measures of motor function.
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| 9. |
- Björk, Tabita, 1966-, et al.
(författare)
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Male experiences of life after recovery from an eating disorder
- 2012
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Ingår i: Eating Disorders. - Oxfordshire, United Kingdom : Taylor & Francis. - 1064-0266 .- 1532-530X. ; 20:5, s. 460-8
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe how former male patients perceive life after recovery from an eating disorder. A qualitative method with a phenomenographic approach was used to identify ways of experiencing recovery. Two descriptive categories were developed: body acceptance and self-worth. Six conceptions describe how recovered patients now relate in a balanced way to exercise and food, using strategies to avoid relapse. With a sense of self-acceptance and autonomy, they now appreciate their social life. Some perceive recovery as coping with remaining impulses to diet or exercise. Others experience themselves as totally free from the eating disorder.
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| 10. |
- Björk, Tabita
(författare)
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Measuring eating disorder outcome : definitions, dropout and patients' perspectives
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Despite a plethora of research, there are serious limitations in our knowledge of outcome in eating disorders. Almost all studies have been compromised by the problem of treatment dropout or non-participation in follow-ups. There exists a lack of consensus in definitions of outcome and choice of outcome measures, and there is a dearth of studies focusing on how patients subjectively perceive recovery. The overall aim of this thesis was to address problems in measuring outcome after treatment for eating disorders, with an emphasis on methodological issues. Specific areas of investigation included non-participation in long-term follow-ups, the role of self-image in treatment dropout, outcome among patients who drop out, patients’ subjective perspectives of recovery, and the impact of different methods of measuring outcome. Method: Four quantitative studies (I, II, III and V) were conducted within the framework of a large Swedish multi-centre study of eating disorders, which adopted a prospective, longitudinal and naturalistic design. Study IV was a qualitative investigation encompassing interviews with former ex-patients who were considered recovered. Results: Study I suggested that the reasons for non-participation in research were mainly patient related (69%). Those declining further participation in follow-ups were reported significantly lower levels of obsession-compulsion and anxiety, while those not traceable reported significantly higher levels of hostility at admission. Study II suggested that patients who dropped out from treatment initially presented with less negative self-image and fewer psychological problems compared to those who remained in treatment. Low levels of self-blame discriminated dropouts from completers and remainers, and significantly predicted treatment dropout. Study III found no significant differences between dropouts and completers at follow-up, with the exception that dropouts were more dissatisfied with treatment. However, patterns of treatment response revealed that those who completed treatment made significantly greater changes in terms of reduced eating disorder symptoms, fewer psychological problems and a more positive self-image compared to dropouts. Study IV found that patients who had recovered from an eating disorder tended to describe other dimensions of outcome than those usually reported in follow-ups. Patients tended to view recovery in terms of being able to relate in a relaxed and accepting manner to food, their bodies, themselves as individuals, and their social environment. Some perceived recovery in terms of coping better with emotions, while others experienced themselves as healthier than people generally regarding food and weight. Study V applied some of the most frequently used outcome measures for eating disorders and found marked variations in the number of patients who could be considered in remission. Overall remission rates varied from 24.3% to 77.8%, depending on the outcome measure used. Discussion: The results suggest that non-participation and dropout are not unitary phenomena. There is also a need for greater consensus on how eating disorder outcome should be measured. This is necessary in order to make comparisons between different outcome studies meaningful, and to elucidate the overall picture of eating disorders outcome.
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