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J Thibaudeau

Publications and source records attributed to J Thibaudeau.

6 recordsLinked to original sources
PubMed1993

Prognostic value of pretreatment social adaptation in bulimia nervosa.

We evaluated several indices of pretreatment social adaptation (social and vocational adjustment, DSM-III-R Axis-V ratings, and "object-relations" capacities) as predictors of the response of 44 completers of a multimodal therapy for bulimia nervosa. Response was assessed using standard measures of eating and psychiatric symptoms. Hierarchical regressions revealed that pretreatment social adjustment explained substantial (and significant) proportions of variance in posttreatment binge/purge symptoms, after variance associated with (a) initial severity of eating symptoms and (b) concurrent psychiatric symptoms (at posttreatment) was accounted for. Hence, social adjustment emerged as a somewhat specific predictor of response of bulimic behaviors. Possible clinical implications of this apparent predictive effect are discussed.

Adolescent↗
PubMed1993

Prognostic utility of subcomponents of the borderline personality construct in bulimia nervosa.

We examined various components of the 'borderline personality construct' as predictors of initial response to treatment in 61 bulimic patients. At pre-treatment, a 'borderline/non-borderline' distinction was established using DSM III-R criteria, and other components of 'borderline' pathology ('borderline traits', object-relations disturbances, maladaptive defences and mood pathology) were assessed using self-report. Self-reported eating and psychiatric symptoms were obtained at initial and three-month evaluations. Using hierarchical regression analyses, we controlled effects of initial eating and psychiatric symptoms, and then evaluated various measures of the borderline construct as predictors of later symptom severity. Categorical borderline PD diagnoses were linked to poorer response on eating attitudes and symptoms, and fine-grained analyses indicated that this prognostic effect might be mediated by mood and object-relations disturbances. Findings therefore seemed to isolate specific subcomponents of borderline personality pathology that predicted poorer response on eating symptoms.

Adult↗
PubMed1966

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Adolescent↗
PubMedDate not supplied

Comorbid features in bulimics before and after therapy: are they explained by axis II diagnoses, secondary effects of bulimia, or both?

This study evaluated the extent to which personality disorder (PD) diagnoses drawn in active bulimics explained pretreatment and posttreatment comorbid features, once possible secondary effects of bulimia nervosa (BN) on the mental status were controlled. We used structured interviews to assign axis II diagnoses to 73 DSM-III-R bulimics, and then examined whether or not classification into borderline PD (BPD), other PD (OPD), or no PD (NPD) groups (a) predicted pretreatment and posttreatment differences in comorbid symptoms, and (b) explained the severity of comorbid symptoms independent of effects attributable to BN sequelae. Groups never differed on eating-symptom measures, with all showing satisfactory average improvements over 3 months. However, on pretreatment and posttreatment comorbid symptoms, BPD subjects displayed more depression, reliance on maladaptive defenses, and other pathological features than did other groups. More importantly, after controlling for the effects of possible sequelae of BN on comorbid symptoms at each point in time, a borderline/nonborderline distinction always explained significant residual proportions of variance in comorbid symptoms. These findings suggest that despite tendencies for BN to exacerbate concurrent symptoms, axis II diagnoses remain meaningful as indicators of comorbid features.

Adult↗
PubMedDate not supplied

Eating and psychiatric symptoms as a function of Axis II comorbidity in bulimic patients. Three-month and six-month response after therapy.

Using DSM-III-R criteria, the authors organized 61 bulimic patients into "Borderline," "Other Personality Disorder," and "No Personality Disorder" groups, and then examined eating and comorbid symptoms at 3-month intervals during 6 months of multimodal therapy. Personality-disorder classifications seemed to predict neither the severity nor responsiveness to treatment of bulimic symptoms; all groups showed reliable and clinically significant improvements in eating habits over time. Conversely, the borderline patients showed reliably more comorbid symptoms than did any other group; their scores on disorder-specific dimensions--like borderline "traits" and maladaptive defenses--remained distinctly elevated throughout treatment. Our findings indicate that 1) a "borderline/nonborderline" distinction predicts temporally stable--and theoretically meaningful--differences in comorbid profiles, and 2) there exists an intriguing degree of independence, at least during ongoing treatment, between severity of character pathology and degree of change obtained on eating symptoms. Theoretical and clinical implications are discussed.

Adult↗