Biomedical subjects

C G Fairburn

Publications and source records attributed to C G Fairburn.

At least 73 records · Page 4Linked to original sources

PubMed1994

Changes in selective information processing with three psychological treatments for bulimia nervosa.

Data from a treatment trial were used to test whether interference with colour-naming eating, shape and weight related words on the Stroop colour-naming task changed with treatment. Interference decreased with treatment and there was no difference between three treatments in the size of this effect. These findings suggest that interference with colour-naming words related to eating, shape and weight in subjects with bulimia nervosa may be a useful objective measure of patients' concerns about these issues.

Adolescent↗

PubMed1994

Eating habits and attitudes of mothers of children with non-organic failure to thrive.

The eating habits and attitudes concerning body shape and weight among 26 mothers of children with non-organic failure to thrive (the index group) were studied using the eating disorder examination. They were compared with equivalent data on 26 individually matched women who participated in a large community survey. The index mothers' views of their child's weight and shape were also studied. The principal findings were, firstly, that when compared with the comparison group, mothers of children with non-organic failure to thrive had higher levels of dietary restraint. Secondly, despite their child's low weight, 50% of the index mothers were restricting their child's intake of 'sweet' foods, and a further 30% were restricting foods they considered 'fattening' or 'unhealthy'. These results raise the question of whether maternal eating habits and attitudes have a causal role in the genesis of non-organic failure to thrive. They suggest that careful inquiry about the mothers' eating habits and attitudes is needed when assessing children with non-organic failure to thrive.

Adult↗

PubMed1994

Sexual abuse and bulimia nervosa: three integrated case control comparisons.

OBJECTIVE: This study had three aims: to determine whether sexual abuse increases the risk of developing bulimia nervosa, to see whether any increase in risk is specific to bulimia nervosa, and to determine whether patients referred for treatment of bulimia nervosa differ from a community group of subjects with bulimia nervosa with respect to their exposure to sexual abuse. METHOD: A case control design with individual matching was used. There were three related case control comparisons. Fifty community-based subjects with bulimia nervosa were compared with 100 community-based comparison subjects without an eating disorder, 50 community-based comparison subjects with other psychiatric disorders, and 50 patients (secondary referrals) with bulimia nervosa. An investigator-based interview was used to assess sexual abuse. RESULTS: Sexual abuse involving physical contact was reported by a minority of the community-based subjects with bulimia nervosa. It was more common among this group than among the normal comparison subjects. There was no difference between the community-based subjects with bulimia nervosa and either the subjects with general psychiatric disorders or the patients with bulimia nervosa. CONCLUSIONS: While the findings indicate that sexual abuse is a risk factor for the development of bulimia nervosa, it does not appear to be specific to bulimia nervosa nor is it relevant to most cases. Sexual abuse appears to be a risk factor for psychiatric disorder in general (including bulimia nervosa) among young adult women. There was no evidence that secondary referrals of bulimia nervosa are biased with respect to sexual abuse.

Adolescent↗

PubMed1994

Cognitive therapy.

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Anorexia Nervosa↗

PubMed1994

Assessment of eating disorders: interview or self-report questionnaire?

A detailed comparison was made of two methods for assessing the features of eating disorders. An investigator-based interview was compared with a self-report questionnaire based directly on that interview. A number of important discrepancies emerged. Although the two measures performed similarly with respect to the assessment of unambiguous behavioral features such as self-induced vomiting and dieting, the self-report questionnaire generated higher scores than the interview when assessing more complex features such as binge eating and concerns about shape. Both methods underestimated body weight.

Adolescent↗

PubMed1993

Psychotherapy and bulimia nervosa. Longer-term effects of interpersonal psychotherapy, behavior therapy, and cognitive behavior therapy.

OBJECTIVE: To determine whether cognitive behavior therapy (CBT) for bulimia nervosa has a specific therapeutic effect and determine whether a simplified behavioral treatment (BT) of CBT is as effective as the full treatment. DESIGN: Randomized controlled trial involving three psychological treatments. Two planned comparisons, CBT with interpersonal psychotherapy (IPT), and CBT with BT. Closed 12-month follow-up period. Independent assessors. SETTING: Secondary referral center. PATIENTS: Seventy-five consecutively referred patients with bulimia nervosa. Patients with concurrent anorexia nervosa were excluded. INTERVENTIONS: Cognitive behavior therapy, IPT, BT conducted on an individual outpatient basis. There were nineteen sessions over 18 weeks. Six experienced therapists administered all three treatments. There was no concurrent treatment. MAIN OUTCOME MEASURE: Frequency of binge eating and purging. RESULTS: High rate (48%) of attrition and withdrawal among the patients who received BT. Over follow-up, few patients undergoing BT met criteria for a good outcome (cessation of all forms of binge eating and purging). Patients in the CBT and IPT treatments made equivalent, substantial, and lasting changes across all areas of symptoms, although there were clear temporal differences in the pattern of response, with IPT taking longer to achieve its effects. CONCLUSIONS: Bulimia nervosa may be treated successfully without focusing directly on the patient's eating habits and attitudes to shape and weight. Cognitive behavior therapy and IPT achieved equivalent effects through the operation of apparently different mediating mechanisms. A further comparison of CBT and IPT is warranted. The behavioral version of CBT was markedly less effective than the full treatment.

Adolescent↗

PubMed1993

Demographic and clinical correlates of selective information processing in patients with bulimia nervosa.

Demographic and clinical correlates of interference with color-naming words related to eating, weight, and shape were investigated in 75 patients with bulimia nervosa. Interference with color-naming was related to two measures, overall level of psychiatric symptoms and frequency of purging. Multiple regression analysis showed that frequency of purging, and not level of general psychiatric symptoms, was the best predictor of interference. Thus, as would be predicted by cognitive theories, interference appears to be most closely related to features specific to bulimia nervosa rather than to measures of general psychopathology.

Adolescent↗

PubMed1993

The classification of recurrent overeating: the "binge eating disorder" proposal.

It has been suggested that a new diagnostic category be added to the section on eating disorders in DSM-IV. This new diagnosis has been termed binge eating disorder. In this article we argue that for two main reasons it would be a mistake to include binge eating disorder in DSM-IV: first, too little is known about binge eating and other related forms of recurrent overeating to justify its inclusion in DSM-IV; and second, its inclusion would be a source of diagnostic confusion. We argue that it is premature to crystallize this specific subgroup from amongst those who recurrently overeat and that to do so would impede the acquisition of knowledge rather than enhance it. We advocate a research strategy that involves studying broad samples of those with recurrent overeating rather than narrow ones.

Anorexia Nervosa↗

PubMed1993

Confusion over the core psychopathology of bulimia nervosa.

There has been particular confusion concerning two aspects of the psychopathology of bulimia nervosa: dissatisfaction with body shape and overvalued ideas about shape and weight. Whilst these features are closely related, they are nevertheless distinct. Body shape dissatisfaction is commonly found in these patients but is not necessarily present; whilst the over-valued ideas about shape and weight are a necessary diagnostic feature. Analysis of the relationship between these two features and depressed mood and self-esteem showed that, in the course of treatment, change in body shape dissatisfaction was closely associated with change in mood; and change in the overvalued ideas was closely associated with change in self-esteem. This finding supports the distinction between these two facets of the core psychopathology of bulimia nervosa.

Body Image↗

PubMed1993

Eating disorders among women receiving treatment for an alcohol problem.

To evaluate the frequency of eating disorder features among women receiving treatment for an alcohol problem, 52 female attenders at an alcohol clinic were assessed using a standardized research clinical interview, and the findings compared with data on a general population sample. The results suggest that eating disorder features are overrepresented among women who present for treatment for an alcohol problem.

Adolescent↗

PubMed1993

An experimental study of the relationship between thoughts and eating behaviour in bulimia nervosa.

This study tested the hypothesis that cognitive disturbance has a causal role in the maintenance of disturbed eating in bulimia nervosa. Thoughts about eating, weight and shape were activated in one group of patients with bulimia nervosa (the experimental group) but not in another (the control group). There was an increase in negative self-statements in the experimental group following the experimental manipulation. Food consumption was then measured in a taste test. As predicted, the experimental group ate less in the short term than the control group. Contrary to expectations, they did not subsequently report more objective bulimic episodes as a consequence of this decreased food intake. They did, however, report significantly fewer subjective bulimic episodes.

Adult↗

PubMed1993

Changes during treatment for bulimia nervosa: a comparison of three psychological treatments.

Seventy-five patients with bulimia nervosa were treated with cognitive behaviour therapy, behaviour therapy or interpersonal psychotherapy. The changes that occurred during treatment were assessed in a subsample of 38 patients. There was an immediate decrease in the frequency of binge-eating and purging (self-induced vomiting or laxative misuse). This continued for 4 wk in interpersonal psychotherapy and for 8 wk in the other two treatment conditions. There were no clear differences between the three treatments in the time course of their effects on a global measure of eating behaviour and attitudes or on measures of depression and self-esteem. The findings suggest that certain shared 'non-specific' properties of psychological treatments can have a substantial early effect on the eating behaviour of patients with bulimia nervosa. Indeed, patients with bulimia nervosa may be particularly likely to show non-specific treatment effects. Cognitive behaviour therapy and behaviour therapy appear to have an immediate influence on eating behaviour over and above these non-specific effects. The study gave no clues as to the mechanism of action of interpersonal psychotherapy.

Adult↗

PubMed1993

Cognitive treatments for eating disorders.

Cognitive-behavioral therapy (CBT) is applicable to all eating disorders but has been most intensively studied in the treatment of bulimia nervosa (BN). CBT is designed to alter abnormal attitudes about body shape and weight, replace dysfunctional dieting with normal eating habits, and develop coping skills for resisting binge eating and purging. CBT is effective in reducing all core features of BN and shows good maintenance of therapeutic improvement. Although superior to therapy with antidepressant drugs, CBT has not been shown to be consistently superior to alternative psychological treatments. Different hypotheses about CBT's mechanisms of action are discussed.

Adaptation, Psychological↗

PubMed1993

Predictors of 12-month outcome in bulimia nervosa and the influence of attitudes to shape and weight.

Seventy-five patients with bulimia nervosa were treated with 1 of 3 short-term psychological treatments and were then entered into a closed 1-year period of follow-up. Pretreatment predictors of 3 measures of outcome were sought. Only 2 variables were significantly associated with outcome: attitudes toward shape and weight, and self-esteem. The nature of the relation between attitudinal disturbance and outcome was complex and unexpected. The data set was also used to test the major prediction of the cognitive view of bulimia nervosa, namely that among patients who have responded to treatment, the residual level of attitudinal disturbance will predict subsequent outcome. This prediction was confirmed.

Attitude↗

PubMed1992

Thoughts about eating, weight and shape in anorexia nervosa and bulimia nervosa.

Concurrent verbalisation and a self-report questionnaire were used to investigate self-statements in patients with anorexia nervosa, patients with bulimia nervosa, two groups of dieters and non-dieting controls. Thoughts were collected while subjects performed three behavioural tasks, looking at themselves in a full-length mirror, weighing themselves and eating a chocolate covered mint. Both groups of patients had more negative thoughts related to eating, weight and shape than those in the three control groups. In addition, patients with anorexia nervosa showed a greater concern with eating while patients with bulimia nervosa showed a greater concern with weight and appearance. Differences were found between the patients and non-dieting controls using both methods but the self-report questionnaire was less sensitive than concurrent verbalisation to differences between the patients and dieters. Implications of the findings for cognitive-behavioural treatments of the two disorders are discussed.

Adult↗

PubMed1992

Crying following stroke. A report on 30 cases.

Following stroke, many patients experience a heightened tendency to cry. The aim of the present study was to provide a detailed description of this behavior and its accompaniments. Thirty stroke patients who had cried in the previous month were studied using a detailed structured clinical interview. There was a wide range of frequency of crying. The components of crying combine in a more complex and varied way than commonly held stereotyped views suggest. No distinct subtypes were identified. Further research is required to determine the relationship between emotionalism and the frequency and severity of symptoms of depression.

Activities of Daily Living↗

PubMed1992

Evaluation of a new instrument for the detection of eating disorders in community samples.

The aim of this study was to develop and evaluate an instrument to detect the various forms of clinical eating disorder that exist among young women in the community. A subsidiary aim was to test an alternative instrument based directly on the DSM-III-R criteria for eating disorders. Participants were 285 young adult women listed in the case registers of two general practices. Receiver operating characteristic analysis showed that the new (statistically derived) instrument performed well and was better at case identification than the only other instrument currently available. In contrast, the instrument based directly on the DSM-III-R criteria performed poorly. It was not possible to assess the ability of the new instrument to detect cases of anorexia nervosa since there were no cases in the sample.

Adolescent↗

PubMed1992

The Present Behavioural Examination (PBE): the development of an interview to measure current behavioural abnormalities.

Behavioural problems are an important feature of dementia and other neuropsychiatric conditions. This paper describes the development and performance of an investigator-based interview (the PBE) for the detailed assessment of the behaviour of subjects over the preceding four weeks. The interview is designed to be administered to carers. A test-retest reliability study was carried out on the penultimate edition of this interview; and the inter-rater reliability of the final edition was measured. These studies show that the reliability of the PBE is comparable with that of other investigator-based interviews.

Aged↗