Biomedical subjects

Deborah L Reas

Publications and source records attributed to Deborah L Reas.

13 recordsLinked to original sources

PubMed2007

Timing and sequence of the onset of overweight, dieting, and binge eating in overweight patients with binge eating disorder.

OBJECTIVE: To examine the self-reported sequence and timing of onset of overweight, binge eating, and dieting in adult patients diagnosed with binge eating disorder (BED). METHOD: Participants were 284 treatment-seeking adults (73 men and 211 women) who met DSM-IV research criteria for BED. Patients were interviewed with structured diagnostic interviews and were queried regarding history of overweight, dieting, and binge eating behaviors. Questionnaires were also administered to assess current eating disturbances, body dissatisfaction, and general functioning. Participants were classified as Overweight First, Binge First, or Diet First, and the three groups were compared on developmental sequence and using the battery of measures. RESULTS: Sixty-three percent of the 284 participants reported becoming overweight prior to the onset of dieting or binge eating. Participants who reported they were overweight first had significantly greater BMI at the time of assessment. The 16% of the participants who reported binge eating first were significantly younger at the onset of BED diagnosis and reported significantly less dietary restraint. Onset order differed significantly by gender; proportionally more women (25%) than men (11%) reported that dieting preceded overweight or binge eating. CONCLUSION: Weight problems preceded dieting and binge eating behaviors for a majority of treatment-seeking overweight participants diagnosed with BED.

Adaptation, Psychological↗

PubMed2006

Body Checking Questionnaire: psychometric properties and clinical correlates in obese men and women with binge eating disorder.

OBJECTIVE: Body checking is considered a behavioral manifestation of the overevaluation of shape and weight, which is characteristic of patients with eating disorders. We examined the initial psychometric properties of the Body Checking Questionnaire (BCQ) and the frequency and nature of body checking behaviors in obese men and women with binge eating disorder (BED). METHOD: Participants were a consecutive series of 73 (22 men, 51 women) treatment-seeking obese adults who met research criteria for BED as defined in the 4th ed. of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994). Participants were administered measures to assess body checking, body image concerns, and the core psychopathology of eating disorders, and general psychological functioning. Semistructured interviews were used to establish the diagnosis of BED. RESULTS: Psychometric evidence was found to support the reliability and validity of the BCQ in patients with BED. Women reported significantly greater levels of body checking than men. Participants with greater body dissatisfaction reported more frequent checking than participants with less dissatisfaction. Among women, the frequency of checking was related to younger age, lower body mass index (BMI), body dissatisfaction, overevaluation of body shape and weight, greater depression, and lower self-esteem. CONCLUSION: There exist significant gender and age-related differences in both the frequency and correlates of body checking behaviors. Among obese women with BED, body checking is related to the overevaluation of shape as well as with associated psychopathology.

Body Image↗

PubMed2006

Reliability of the Eating Disorder Examination-Questionnaire in patients with binge eating disorder.

This study examined the test-retest reliability of the Eating Disorder Examination-Questionnaire (EDE-Q) in patients with binge eating disorder (BED). Short-term (mean days = 4.8; SD = 3.6) test-retest reliability of the EDE was examined in a sample of 86 patients with BED. Test-retest reliability was excellent for objective bulimic episodes (correlation = .84), but poor to unacceptable for subjective bulimic episodes and objective overeating episodes (correlations = .51 and .39, respectively). Test-retest reliabilities were good for the EDE-Q scales (correlations = .66 to .77), albeit somewhat variable for the individual EDE-Q items (.54 to .78). These findings support the reliability of the EDE-Q for patients with BED. The EDE-Q has utility for assessing the number of binge eating episodes (objective bulimic episodes) and associated features of eating disorders in patients with BED. The results for subjective bulimic episodes are consistent with previous studies in suggesting that these eating behaviors may not be reliable indicators of eating disorders for patients with BED.

Adult↗

PubMed2005

Body checking and avoidance in overweight patients with binge eating disorder.

OBJECTIVE: Repetitive body checking and avoidance are viewed as behavioral manifestations of the core psychopathology of eating disorders (EDs). We examined select body checking and avoidance behaviors in overweight patients with binge eating disorder (BED). METHOD: Three hundred seventy-seven overweight (body mass index [BMI] > or = 25) treatment-seeking BED patients (80 men and 297 women) were administered measures to assess body checking and avoidance, other key behavioral features of EDs (binge eating, dietary restraint, and disinhibition), and the core psychopathology of EDs (overevaluation of weight and shape). RESULTS: The majority of participants reported regularly pinching areas of their body to check for fatness and avoided wearing clothing that made them particularly aware of their body. Significant associations emerged between checking and restraint, and conversely, between avoidance and binge eating. Both checking and avoidance were positively and significantly associated with overevaluation of weight and shape, even after controlling for their unique effects. DISCUSSION: These findings offer support to the potential role of checking and avoidance behaviors in the maintenance of BED.

Adult↗

PubMed2005

Characteristics of anorexia nervosa-related deaths in Norway (1992-2000): data from the National Patient Register and the Causes of Death Register.

OBJECTIVE: This study investigated demographic and diagnostic characteristics of individuals whose medical record or death certificate indicated the presence of anorexia nervosa at the time of death. METHOD: Two national registers, the National Patient Register (NPR) and the Causes of Death Register (CODR), were examined in Norway for anorexia nervosa-related deaths occurring across a 9-year period (1992-2000). RESULTS: The medical record or death certificate listed anorexia nervosa as a diagnosis or cause of death for 66 individuals. Rates of death were 6.46 and 9.93 per 100,000 deaths for the NPR and the CODR, respectively. A substantial percentage of deaths (43.9%) in both registers occurred at or above the age of 65 years. For the NPR, the mean age at the time of death was 61 years and 31% of deaths occurred among men. For the CODR, the mean age at the time of death was 49 years and 18% of deaths occurred among men. DISCUSSION: Potential merits and shortcomings of assessing mortality rates using register-based data without linkage to a previously identified clinical sample are discussed.

Adolescent↗

PubMed2005

Body checking and avoidance and the core features of eating disorders among obese men and women seeking bariatric surgery.

This study examined two aspects of body checking and avoidance, and their relations to the core psychopathology of eating disorders (EDs), in severely obese men and women seeking bariatric surgery. A consecutive series of 260 (44 male and 216 female) gastric bypass candidates were administered measures to assess body checking and avoidance, binge eating, restraint, and overevaluation of weight and shape. The majority of patients reported regularly pinching areas of their body to check for fatness and avoided wearing clothing that made them particularly aware of their body. Significant associations were observed between checking and restraint, and between avoidance and binge eating. Both checking and avoidance behaviors were significantly associated with overevaluation of weight and shape. The positive associations between each of the two behaviors (body checking and avoidance) with overevaluation of weight/shape remained significant even after controlling for the effects of avoidance on body checking and vice versa. Stepwise multiple regression analyses revealed that binge eating, body checking, and avoidance behaviors made significant unique contributions and jointly accounted for 22-25% of the variance in overevaluation of weight and shape, respectively. This study documents the presence of eating disorder psychopathology among severely obese patients seeking bariatric surgery. The findings support the view that body checking and avoidance behaviors are manifestations of overevaluation of weight and shape and disordered eating.

Adult↗

PubMed2004

Is schizoaffective disorder a stable diagnostic category: a retrospective examination.

Debate continues about whether clear nosologic boundaries can be drawn between schizoaffective disorder (SA), schizophrenia (SP), and bipolar disorder (BPD). This study attempted to clarify these boundaries. A retrospective review of the records of adult psychiatric inpatients with DSM-IV diagnoses of SA (n = 96), SP (n = 245), and BPD (n = 203) was conducted. Patients were assessed at admission and discharge using standardized rating scales (completed by physicians and nurses) and self-report inventories. Differential improvement over time also was examined. Significant differences were found for gender, legal status at admission, age, LOS, episode number, and ethnicity. Overall, SA was rated by clinicians as intermediate between SP and BPD, although SA rated themselves as the most severe. SA was similar to SP on positive symptoms, intermediate on negative symptoms, and similar to BPD on mood- and distress-related symptoms. Independent of diagnosis, differences in change scores from admission to discharge were related to severity level at admission. Although several differences were found in symptom severity across domains, no syndrome was identifiable associated with the diagnosis of SA and the diagnosis was unstable over time, thereby bringing into question the validity of SA as a diagnostic entity.

Brief Psychiatric Rating Scale↗

PubMed2004

Appearance vs. health reasons for seeking treatment among obese patients with binge eating disorder.

OBJECTIVE: This study examined reasons for seeking treatment reported by obese patients diagnosed with binge eating disorder (BED). RESEARCH METHODS AND PROCEDURES: Participants were 248 adults (58 men and 190 women) who met DSM criteria for BED. Participants were recruited through advertisements for treatment studies looking for persons who wanted to "stop binge eating and lose weight." Patients' reasons for seeking treatment were examined with respect to demography (gender and age), obesity (BMI and age of onset), features of eating disorders, and associated psychological functioning (depression and self-esteem). RESULTS: Of the 248 participants, 64% reported health concerns and 36% reported appearance concerns as their primary reason for seeking treatment. Reasons for seeking treatment did not differ significantly by gender. Patients seeking treatment because of appearance-related reasons had lower BMIs than those reporting health-related reasons (34.8 vs. 38.5, respectively), but they reported greater body dissatisfaction, more features of eating disorders, and lower self-esteem. DISCUSSION: Reasons that prompt treatment seeking among obese individuals with BED reflect meaningful patient characteristics and, therefore, warrant assessment and consideration during treatment planning. Further research is needed to determine whether reasons for treatment seeking among different obese patient groups affect treatment outcomes.

Adult↗

PubMed2004

Cognitive-behavioral assessment of body image disturbances.

The construct of body image is multidimensional in nature and multidisciplinary in scope. The purpose of this review is to help clinicians navigate the basic theoretical and practical considerations associated with body image assessment. Common pitfalls reflect methodological problems and conceptual confusion surrounding the subjectivity, heterogeneity, lability, and complexity of the body image construct. By highlighting these core concepts, we provide a framework for conducting a comprehensive cognitive-behavioral assessment to inform case formulation and treatment planning. The strength and utility of a cognitive-behavioral therapy (CBT) model lies in its broad applicability and ability to identify the proximal factors that precipitate and maintain body image concerns, such as distorted patterns of thinking and maladaptive behavior (e.g., body checking, mirror gazing, avoidance, social comparison, reassurance seeking). Although the evidence base is still evolving, the basic tenets of a CBT approach appear to transcend disciplines and specialties. The article concludes by providing an example of self-monitoring, which is a cornerstone of CBT assessment and treatment, and referencing the steps of an established CBT manualized treatment program.

Body Image↗

PubMed2003

Assessing worry in older adults: confirmatory factor analysis of the Penn State Worry Questionnaire and psychometric properties of an abbreviated model.

The assessment of worry among older adults typically has involved measures designed with younger cohorts. Because of special concerns in assessing older adults, modifications to existing instruments may be necessary. Addressing equivocal factor analytic data on the Penn State Worry Questionnaire (PSWQ) among younger adults, the authors conducted confirmatory factor analyses to evaluate the generalizability of previous models to older adults with generalized anxiety disorder. Data fit poorly with established single- and two-factor models. The single-factor model was modified, resulting in the elimination of 8 items, strong fit indices, high internal consistency, adequate test-retest reliability, and good convergent and divergent validity. Further psychometric work is required to assess whether the revised model is a more parsimonious method to assess late-life anxiety.

Aged↗

PubMed2002

Day hospitalization programs for eating disorders: a systematic review of the literature.

OBJECTIVE: Partial day hospitalization programs for the treatment of eating disorders are increasingly being developed worldwide. METHOD: First, a systematic database search of day hospitalization programs for eating disorders, published in either English or German, was conducted. Programs that provided sufficient information on their program structure were summarized and compared across various dimensions. Second, the responsible program directors were contacted to provide additional information regarding outcome data, current trends, challenges, and future directions of their programs. Third, outcome data from day programs presented at international conferences were included to expand the base of the review. DISCUSSION: Although the programs from different countries and health care environments varied in terms of their purpose and operated within very different health care systems, many similarities were found to exist, including the use of a multidisciplinary staff and reliance on group treatment as the primary means of therapy. Marked differences were noted in terms of inclusion criteria and intensity of care.

Day Care, Medical↗

PubMed2002

Development of the body checking questionnaire: a self-report measure of body checking behaviors.

OBJECTIVE: The purpose of this study was to develop a brief self-report inventory to assess body checking behaviors. METHOD: Using exploratory and confirmatory factor analyses, the 23-item Body Checking Questionnaire (BCQ) was developed. The BCQ measures the global construct of body checking behaviors with three correlated subfactors that assess checking related to overall appearance, checking of specific body parts, and idiosyncratic checking rituals. RESULTS: The BCQ was found to have good test-retest reliability (.94) and the subfactors had good internal consistency (.88, .92, and .83). The measure correlated highly with other measures of negative body image and eating disorders, demonstrating its concurrent validity. Additionally, the BCQ was found to differentiate normal controls and eating disorder patients, as well as nonclinical participants scoring high and low on a measure of concern with body size and dieting. DISCUSSION: Due to the potential role of ritualistic body checking in the maintenance of body dissatisfaction by directing excessive attention to body shape/weight, the BCQ may prove to be a useful clinical tool in the assessment and treatment of eating disorder patients.

Adolescent↗

PubMed2002

Concurrent validity of the Wechsler abbreviated scale of intelligence and the Kaufman brief intelligence test among psychiatric inpatients.

This study examined the convergent and discriminant validity of the Wechsler Abbreviated Scale of Intelligence and the Kaufman Brief Intelligence Test for 85 psychiatric inpatients. The correlation between the WASI Full Scale and K-BIT Composite IQ scores was significant (r = .89, p < .001). Multitrait-multimethod analysis of the subtest scores showed that the K-BIT had higher internal consistency for its two subtests but, therefore, less differentiation of cognitive functioning than the brief Wechsler scale, as would be expected due to the larger number and diversity of the latter subtests. Correlations among the Wechsler scale subtests were lower than among those for the K-BIT, so the former may tap different cognitive functions and yield more clinically useful information than the latter. This brief Wechsler scale appears to be a valid screening measure of verbal, performance. and general intellectual ability for use with an inpatient psychiatric population when considerations of the setting or patient preclude administration of a longer measure of intellectual ability.

Adult↗