Biomedical subjects

C M Grilo

Publications and source records attributed to C M Grilo.

71 records · Page 4Linked to original sources

PubMed1993

Eating, weight, and dieting disturbances in male and female lightweight and heavyweight rowers.

Rowers compete in a sport that allows comparison of male and female athletes and where some (lightweight) but not others (heavyweights) must meet specific weight criteria. Eating attitudes, dieting patterns, weight fluctuation, and methods of weight loss were evaluated in 162 rowers: 82 heavyweights (56 females, 26 males) and 80 lightweights (17 females, 63 males). Females displayed more disturbed eating practices and weight control methods than did males. Lightweights did not have more disturbed eating practices than heavyweights, but employed more extreme weight loss methods. Male rowers were more affected by weight restriction than were female rowers. Lightweight males showed greater weight fluctuation during the season and gained more weight during the offseason than did lightweight females and heavyweight males and females. These results indicate that rowing can join the growing list of sports where eating and weight disturbances may be present. Male athletes may be more vulnerable to these problems than previously recognized.

Adult↗

PubMed1991

The nature of environmental influences on weight and obesity: a behavior genetic analysis.

The nature of environmental influences on individual differences in weight and obesity is presently unclear. To resolve this issue, behavior genetic studies are reviewed for their relevance to environmental influences on weight and obesity. Results are consistent in suggesting that environmental experiences are important for weight and obesity, although they account for much less variation than do the effects of genes. Furthermore, only environmental experiences that are not shared among family members appear to be important. In contrast, experiences that are shared among family members appear largely irrelevant in determining individual differences in weight and obesity. These conclusions are consistent with a growing body of evidence on the relative unimportance of such shared experiences for many psychological characteristics.

Body Weight↗

PubMed1989

Relapse crises and coping among dieters.

We examined situational antecedents of dieting relapse crises and dieters' attempts to cope with temptations to overeat. We analyzed posttreatment interviews with 57 obese Ss with Type II diabetes, comparing situations in which Ss lapsed with those in which they overcame temptation to overeat. Cluster analysis yielded 3 categories of relapse crises: mealtime, low-arousal, and emotional upset situations. The clusters differed in outcome: Upset situations almost always resulted in overeating; situational factors, especially food-related cues, increased relapse risk; but performance of coping was the strongest correlate of outcome. Cognitive and behavioral coping responses were each equally associated with positive outcomes. When Ss reported combining both types of coping, they were less likely to report overeating. The dynamics of relapse crises among dieters resemble those that govern relapse crises in addictive behaviors.

Adaptation, Psychological↗

PubMedDate not supplied

Coping with dietary relapse crises and their aftermath.

We examined dieters' attempts to cope with dietary relapse crises (Immediate coping) and their aftermath (Restorative coping). We analyzed posttreatment interviews with 57 obese subjects with Type-II diabetes, comparing coping in situations in which subjects lapsed with those in which they survived temptations to overeat. Performance of Immediate coping predicted survival but the particular type of coping made little difference. Eight types of Immediate cognitive coping were equally associated with survival: each was significantly more effective than no coping and equal to the aggregate of the other types. A similar pattern held for 5 types of Immediate behavioral coping, except that social support was no more effective than no coping and restraint was less effective than the other types. Restorative behavioral coping was elicited as a response to overeating, while Restorative cognitive coping seemed elicited by the negative thoughts and feelings that sometimes accompany lapses or temptations. Implications for treatment and future research on relapse crises and coping are discussed.

Adaptation, Psychological↗

PubMedDate not supplied

Eating disorders in female inpatients with versus without substance use disorders.

This study assessed the relationship between substance use disorders and eating disorders in female psychiatric inpatients. Structured diagnostic interviews were reliably administered to a series of inpatients with substance use disorders (n = 67) and a comparison sample without substance use disorders (n = 69). Eating disorder diagnoses as a whole, including eating disorder not otherwise specified, were distributed significantly more frequently among subjects with substance use disorders than among psychiatric controls. Frequencies of the specific diagnoses of bulimia nervosa and anorexia nervosa, however, did not differ significantly between groups. The results suggest that eating disorder features may be overrepresented among female inpatients with substance use disorders.

Adolescent↗

PubMedDate not supplied

Teasing, body image, and self-esteem in a clinical sample of obese women.

This study examined the relationship of physical-appearance-related teasing history to body image and self-esteem in a clinical sample of adult obese females. The frequency of being teased about weight and size while growing up was negatively correlated with evaluation of one's appearance and positively correlated with body dissatisfaction during adulthood. Self-esteem was unrelated to teasing history but covaried significantly with body image measures. Subjects with early-onset obesity reported greater body dissatisfaction than did subjects with adult-onset obesity. The findings suggest that being teased about weight/size while growing up may represent a risk factor for the development of negative body image and that self-esteem and body image covary.

Adult↗

PubMedDate not supplied

Binge eating disorder: a need for additional diagnostic criteria.

This study compares the core and associated features of binge eating disorder (BED) and bulimia nervosa (BN). One hundred twenty-nine adult females who were obese with BED (n = 51) or non-obese with BED (n = 32) or who had BN (n = 46) were compared using the Eating Disorder Examination-Questionnaire (EDE-Q). The BED groups were older and had a higher body mass index (BMI). The 3 groups were similar in binge frequency, but BN subjects (by definition) purged regularly. The groups differed by dietary restraint, even after controlling for BMI and age, such that the BN group had significantly higher dietary restraint than both BED groups. Cognitively, the 3 groups were similar in the intensity of dysfunctional attitudes regarding eating, weight, and shape. The BMI and age were not associated with these dysfunctional attitudes. Our findings suggest the importance of and the need to consider cognitive--as well as behavioral--diagnostic criteria for BED.

Adolescent↗

PubMedDate not supplied

Convergent and discriminant validity of DSM-IV axis II personality disorder criteria in adult outpatients with binge eating disorder.

The study objective was to evaluate the within-category cohesiveness and between-category overlap of DSM-IV axis II personality disorders (PDs) in outpatients with binge eating disorder (BED). Seventy adult outpatients with BED were reliably administered the Diagnostic Interview for DSM-IV Personality Disorders (DIPD-IV). Within-category interrelatedness of the criteria was evaluated by Cronbach's alpha and mean intercriterion correlations (MICs). Between-category criterion overlap was evaluated by examining intercategory mean intercriterion correlations between all pairs of PDs (ICMICs). Cronbach's alpha was .64 to .93 (mean, .77), the MIC was .17 to .52 (mean, .34), and the ICMIC was .11 to .39 (mean, .28). Our findings indicate that in outpatients with BED, the DSM-IV PD criteria sets have convergent validity (acceptable alpha value and MIC). Some degree of discriminant validity also exists: criteria for most DSM-IV PDs correlate better with each other (MIC) than with criteria for other PDs (ICMIC).

Adult↗

PubMedDate not supplied

Eating disorders with and without substance use disorders: a comparative study of inpatients.

We assessed the co-occurrence of DSM-III-R axis I and II disorders and self-reported psychologic distress in inpatients with eating disorders with and without substance use disorders (ED-SUD and ED groups, respectively) and in a matched comparison sample with substance use disorders but no eating disorder (SUD group). The three groups showed similar distributions of axis I disorders but differed in the distribution of axis II disorders. Cluster B personality disorders were diagnosed more frequently in SUD and ED-SUD groups than in the ED group. In contrast, cluster C personality disorders were diagnosed more frequently in the ED group than in SUD and ED-SUD groups. The SUD group reported greater psychologic distress than ED and ED-SUD groups. Possible implications of the observed group differences for psychologic models of why these disorders may be associated are considered.

Adolescent↗

PubMedDate not supplied

Diagnostic comorbidity in hospitalized adolescents with conduct disorder.

We compared the diagnostic comorbidity of DSM-III-R axis I and axis II disorders in a sample of hospitalized adolescents with conduct disorder (CD) and a comparison group of hospitalized adolescents without conduct disorder (non-CD). Of 138 consecutively evaluated adolescents, 76 patients met criteria for CD and 62 did not. On axis I, CD was significantly comorbid with attention-deficit hyperactivity disorder (ADHD) and substance use disorders (SUDs). None of the personality disorders assessed showed differential association with CD. The comorbid relationships found within this sample suggest a strong association between CD, ADHD, and SUD in hospitalized teenagers. This finding underscores the clinical importance of conducting a thorough developmental assessment and, when indicated, of treating ADHD and SUD in conduct-disordered adolescents.

Adolescent↗

PubMedDate not supplied

Psychiatric comorbidity differences in male and female adult psychiatric inpatients with substance use disorders.

To examine gender differences in the co-occurrence of DSM-III-R axis I disorders and axis II personality disorders in young adult psychiatric inpatients with substance use disorders (SUDs), a consecutive series of 70 inpatients (33 men and 37 women) with SUD were reliably assessed with structured diagnostic interviews. Higher rates of dysthymia and eating disorders were observed in SUD females and higher rates of cluster A personality disorders were observed in SUD males. No gender differences were found for depression or anxiety in our SUD inpatients; these findings contrast with gender ratios for these disorders in the general population. In conclusion, relatively few gender differences were found in young adult inpatients with SUD, even where they would be expected based on general population gender patterns.

Adolescent↗

PubMedDate not supplied

Pretreatment patient factors predicting attrition from a multicenter randomized controlled treatment study for panic disorder.

This study examined pretreatment factors associated with attrition from a clinical trial for panic disorder. The study group consisted of 162 patients who began 11-visit treatments. Six domains (demography, panic disorder severity, psychiatric comorbidity, illness/treatment attributions, coping styles, and personality styles) with 52 variables were used to predict attrition. One hundred twenty-two patients completed and 40 dropped out from treatment. Final multivariate regression analyses showed that the following two variables were independently associated with attrition: lower household income and negative treatment attitudes; attributing the panic disorder to life stressors and greater age were independently associated with attrition at the trend level. Preliminary analyses suggested, in addition, associations between attrition and lower education, shorter length of prior treatment, higher anxiety sensitivity, lower agoraphobic avoidance, and a coping style of seeking social support that were not confirmed by best predictor analysis. Psychiatric comorbidity and personality styles were unrelated to attrition. The implications of these findings for future research and clinical practice are discussed.

Adaptation, Psychological↗

PubMedDate not supplied

Correlates of suicide risk in adolescent inpatients who report a history of childhood abuse.

The study objective was to examine correlates of suicide risk in psychiatrically hospitalized adolescents with a reported history of childhood abuse. Predictors of suicide risk were examined in 74 subjects who reported a history of childhood abuse and 53 depressed subjects who did not report a history of childhood abuse. Subjects completed a battery of psychometrically well-established self-report instruments to assess childhood abuse, suicide risk, and internalizing and externalizing psychopathology. Correlational analyses showed that higher levels of depression, self-criticism, and hopelessness were significantly associated with suicide risk in both study groups and violence was significantly associated with suicide risk in the childhood abuse group. For the childhood abuse group, multiple regression analyses with seven predictor variables accounted for 54% of the variance in suicide risk; depression and alcohol problems made significant independent contributions, while violence and self-criticism were independent predictors at the trend level. For the depressed/nonabused group, multiple regression analyses with the seven predictor variables accounted for 60% of the variance in suicide risk; depression, hopelessness, and self-criticism were independent predictors. Our findings suggest that both internalizing (i.e., depression or self-criticism) and externalizing (i.e., violence or alcohol) factors predict suicide risk in adolescent inpatients who report childhood abuse. This profile appears different from the more internalizing pattern (i.e., depression, self-criticism, and hopelessness) observed for the depressed adolescent inpatients who reported no history of childhood abuse.

Adolescent↗

PubMedDate not supplied

Development of the drug abuse screening test for adolescents (DAST-A).

The development and initial validation of the Drug Abuse Screening Test for Adolescents (DAST-A) is summarized. The DAST-A, derived from a modification of the original adult version called the Drug Abuse Screening Test (DAST: Skinner, 1982), was psychometrically tested in a study group of adolescent inpatients. The DAST-A demonstrated good internal consistency, high test-retest reliability, unidimensional factor structure, and good concurrent validity. Using the classification system of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association 1994), DAST-A scores of greater than 6 yielded sensitivity, specificity, and positive predictive powers of 78.6%, 84.5%, and 82.3%, respectively, in differentiating adolescent psychiatric inpatients with and without drug-related disorders. These findings suggest that the DAST-A holds promise as a drug abuse screening measure in psychiatrically impaired adolescent populations.

Adolescent↗

PubMedDate not supplied

Bulimia nervosa and alcohol dependence. A case report of a patient enrolled in a randomized controlled clinical trial.

Bulimia nervosa and alcohol use disorders frequently co-occur. A review of the literature, however, reveals a paucity of information on treatment of patients with these comorbid conditions. We present a case report of a 34-year-old Caucasian female with a 20-year history of bulimia nervosa with co-occurring alcohol dependence, who participated in a randomized placebo-controlled medication augmentation trial for bulimia nervosa. The patient served as a pilot subject who met the exclusionary criterion of alcohol dependence, but received all the assessment and intervention procedures of the clinical trial for bulimia nervosa. Despite double-blind random assignment to a placebo condition, the patient's symptoms of bulimia nervosa substantially improved over the course of the 5-week efficacy trial. We hypothesize that this improvement was due to concurrent abstinence from alcohol rather than a placebo effect.

Adult↗

PubMedDate not supplied

Correlates of community violence exposure in hospitalized adolescents.

To examine psychological and behavioral correlates of community violence exposure in psychiatrically hospitalized adolescents, 89 inpatients were administered a battery of psychometrically well-established self-report instruments. Violence exposure was assessed using the Child's Exposure to Violence Checklist (CEVC). Half of the patients reported exposure to multiple incidents violence in their community (52%) and home (53%). Sixty-one percent were victims of physical assault, and 39% were victims of sexual assault. Patients who had witnessed community violence reported significantly more post-traumatic stress disorder (PTSD) symptoms, drug use, and violence potential than patients without a history of witnessing community violence. Patients exposed to community violence were also more likely to be the victim of childhood maltreatment, as well as a perpetrator of violence. In conclusion, traumatization via exposure to community violence may serve as one important determinant in the development of mixed internalizing and externalizing psychopathology in adolescent inpatients, thus necessitating accurate assessment and treatment planning.

Adolescent↗

PubMedDate not supplied

Stability and change of DSM-III-R personality disorder dimensions in adolescents followed up 2 years after psychiatric hospitalization.

We examined the stability of DSM-III-R personality disorder dimensions in a clinical sample of adolescents. Sixty adolescent inpatients were reliably assessed with the Personality Disorder Examination (PDE) soon after admission to the Yale Psychiatric Institute, and were independently reassessed with the same instrument 2 years following discharge. PDE symptom ratings were summed to create dimensional scores for each personality disorder. To assess the dimensional stability of personality disorders, intraclass correlation coefficients (ICCs) were computed. To assess the magnitude of the difference between baseline and follow-up scores, paired t tests were used. Significant ICCs were observed for histrionic, narcissistic, dependent, obsessive-compulsive, and passive-aggressive personality disorders. Compared to baseline, dimensional scores for most personality disorders were significantly lower at follow-up-and none was significantly higher. Diagnostic stability is a key defining feature of personality disorders. We observed low-to-moderate stability for dimensional measures of personality dysfunction in adolescents-suggesting that previous reports of modest personality disorder stability in this age group cannot be attributed solely to limitations of the categorical approach to such pathology. Alternatively, our findings may be viewed as consistent with reports in the adult literature that personality disorders may improve over time, and can potentially benefit from treatment.

Adolescent↗