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Biomedical subjects

D L Reas

Publications and source records attributed to D L Reas.

8 recordsLinked to original sources

Psychological adjustment in the children of mothers with a history of eating disorders.

In order to test the impact of mothers' eating disorders (EDs) on their children's psychological adjustment, we recruited mothers belonging to three different populations: women with eating disorders, women with depression, and normal controls. The parents responded to self-report inventories relating to psychological adjustment of the parent and child. The study found that the psychological adjustment of the children of mothers with a history of ED was not different from that of the children of mothers in the normal control group, although mothers described significant pregnancy and birth complications, parenting stress, and symptoms of clinical depression. The children of mothers with a history of depression had significantly greater psychological problems in comparison with those of the children of mothers in the other two groups. The results are interpreted in the context of the protective factors that may have buffered the effects of maternal psychopathology in children of mothers with a history of ED.

Adaptation, Psychological↗

Prognostic value of duration of illness and early intervention in bulimia nervosa: a systematic review of the outcome literature.

OBJECTIVE: Early intervention is often regarded as an important step for the prevention of a chronic eating disorder. The primary aim of this review was to systematically evaluate the outcome literature and to better describe the effects of early intervention on the course of bulimia nervosa. METHOD: Twenty-four follow-up studies were subjected to nine "best-evidence" criteria for methodological soundness. Of these 24 studies, 5 met all methodological criteria and were considered in more detail. RESULTS: Only one of these five studies found a significant association between duration of illness and outcome. These studies were re-examined to exclude studies that included patients who were not first admissions in order to distinguish between the effect of duration of illness versus early intervention. This re-examination excluded four of the five studies, and the remaining study provided no data regarding prior treatment. DISCUSSION: Based on this selection of studies, it was concluded that there is no consistent evidence to support that early intervention necessarily implies a better long-term outcome. Due to the multiple methodological problems that plague follow-up studies, future research would be improved by employing designs that directly test the impact of early versus late intervention.

Adolescent↗

Long-term outcome of anorexia nervosa in a prospective 21-year follow-up study.

BACKGROUND: Given our poor understanding of the very long-term course of anorexia nervosa. many questions remain regarding the potential for recovery and relapse. The purpose of the present study was to investigate long-term outcome and prognosis in an anorexic sample 21 years after the initial treatment. METHOD: A multidimensional and prospective design was used to assess outcome in 84 patients 9 years after a previous follow-up and 21 years after admission. Among the 70 living patients, the follow-up rate was 90%. Causes of death for the deceased patients were obtained through the attending physician. Predictors of a poor outcome at the 21-year follow-up were selected based on the results of a previous 12-year follow-up of these patients. RESULTS: Fifty-one per cent of the patients were found to be fully recovered at follow-up, 21% were partially recovered and 10% still met full diagnostic criteria for anorexia nervosa. Sixteen per cent were deceased, due to causes related to anorexia nervosa. The standardized mortality rate was 9.8. The three groups also showed significant differences in psychosocial outcome. A low body mass index and a greater severity of social and psychological problems were identified as predictors of a poor outcome. CONCLUSIONS: Recovery is still possible for anorexic patients after a period of 21 years. On the other hand, patients can relapse, becoming symptomatic again despite previously achieving recovery status. Only a few patients classified as having a poor outcome were found to seek any form of treatment, therefore, it is recommended that these patients should be monitored regularly and offered treatment whenever possible.

Adult↗

Long-term prognosis in anorexia nervosa: lessons from a 21-year follow-up study.

In a prospective long-term follow-up of 84 patients 21 years after first hospitalisation for anorexia nervosa, we found that 50.6% had achieved a full recovery, 10.4% still met full diagnostic criteria for anorexia nervosa, and 15.6% had died from causes related to anorexia nervosa. Predictors of outcome included physical, social, and psychological variables.

Anorexia Nervosa↗

Duration of illness predicts outcome for bulimia nervosa: a long-term follow-up study.

OBJECTIVE: The purpose of this study was to investigate long-term outcome and prognosis in a bulimic and subthreshold bulimic sample. METHOD: In a follow-up study, 44 patients diagnosed with bulimia nervosa and subthreshold bulimia nervosa were contacted after an average follow-up period of 9 years. RESULTS: Results revealed that 72.7% (n = 32) of the participants were recovered at the time of follow-up. An investigation of prognostic variables showed that good outcome was associated with a shorter duration of illness, which was defined as the time between onset of symptoms and first treatment intervention. If participants were initially treated within the first few years of the illness, the probability of recovery was above 80%. However, if they were initially treated 15 years or more after the onset of the illness, the probability of recovery fell below 20%. DISCUSSION: This finding suggests that early identification of bulimia nervosa may be a very important factor in preventing a chronic eating disorder.

Adolescent↗

Body image assessment for obesity (BIA-O): development of a new procedure.

OBJECTIVE: A new measure of body image, named the body image assessment for obesity (BIA-O) was developed and tested for reliability and validity in a sample of 1,209 adult men and women. Separate BIA-O procedures were developed for men and women. Current, ideal and reasonable body image estimates of Caucasian and African-American men and women were compared. METHOD: Figural stimuli of males and females were developed for body sizes ranging from very thin to very obese in 18 increments. Participants selected figures that represented estimates of current, ideal and reasonable (a body size that could be maintained over time) body size. Some participants (n=641) also completed two measures of body dissatisfaction in a test of the validity of the BIA-O as a measure of body dissatisfaction. A sample of 77 participants was administered the BIA-O on two occasions to test the test-retest reliability of the BIA-O. RESULTS: The reliability of the BIA-O was supported by test-retest reliability coefficients which ranged from 0.65 to 0.93. Concurrent validity of the discrepancy between current and ideal and current and reasonable body size estimates was supported by positive correlations with two measures of body dissatisfaction. The BIA-O body size estimates of Caucasians and African-Americans, controlled for age and BMI, were compared. As BMI increased, Caucasian men and women were found to select larger current body size estimates in comparison to African-Americans. DISCUSSION: The reliability and validity of the BIA-O were supported. Greater body size dissatisfaction in obese Caucasians, relative to African-Americans of the same size, may be a function of biased estimates of current body size.

Adolescent↗

Cognitive bias in eating disorders: implications for theory and treatment.

Research testing the predictions of cognitive-behavioral theory related to the psychopathology of eating disorders has lagged behind treatment outcome research. Central to cognitive theories of eating disorders is the hypothesis that beliefs and expectancies pertaining to body size and to eating are biased in favor of selectively processing information related to fatness/thinness, dieting, and control of food intake or body weight. In recent years, controlled investigations of the predictions of cognitive theories of eating disorders have yielded empirical support for these theories. This paper reviews research which has tested the predictions of cognitive-behavioral theory and discusses the implications of these findings for the treatment of eating disorders. Understanding of information processing biases may assist the clinician in understanding a range of psychopathological features of anorexia and bulimia nervosa, including denial, resistance to treatment, and misinterpretation of therapeutic interventions.

Attitude↗

Revelation without presentation: counterfeit study list yields robust revelation effect.

This study explores the revelation effect, a recognition memory phenomenon that occurs when test items (or related items) are specially processed before recognition judgment. These revealed items, whether targets or lures, receive a positive response bias. Although the effect occurs across various conditions, it has not been shown to occur when participants make judgments unrelated to episodic memory. We investigated whether the effect would occur when a recognition decision was nominally one of episodic memory, but when a complete episodic event had not occurred. Specifically, participants listened to noise that allegedly masked a list of words (in fact, no words existed). A revelation effect occurred with this pseudo-subliminal procedure, suggesting that the revelation effect need not rely on stimuli recalled through episodic memory but only a specific event to recall. The effect did not occur when participants simply guessed whether words were on an unheard list or made semantic judgments.

Humans↗