Biomedical subjects

Leslie J Heinberg

Publications and source records attributed to Leslie J Heinberg.

13 recordsLinked to original sources

PubMed2007

Perceived coercion and change in perceived need for admission in patients hospitalized for eating disorders.

OBJECTIVE: Ambivalence toward treatment is characteristic of eating disorders, and patients are often admitted to inpatient programs under pressure from clinicians, family, friends, educators, or employers. This study evaluated patient perceptions of the admissions process and perceived need for hospitalization and assessed whether these perceptions remain stable in the short term. METHOD: A total of 139 patients with eating disorders completed a 13-item self-report scale on the admission experience when they were admitted to a behavioral inpatient specialty program and again 2 weeks into their hospitalization. RESULTS: Patients with anorexia nervosa reported higher levels of perceived coercion and pressure and a lower sense of procedural justice than did those with bulimia. Patients under 18 (N=35) reported more perceived coercion than did adult patients (N=104), and a trend was noted for them to disagree that they needed hospitalization. Perceptions of coercion, of pressure by others toward hospitalization, and of procedural justice were stable in the short term. However, of the 46 patients (30 of them adults) who initially did not endorse needing admission, 20 patients (17 of them adults) changed their minds by 2 weeks into hospitalization and agreed that they needed hospital admission. CONCLUSIONS: Nearly half of patients with eating disorders who denied a need for treatment on admission converted to acknowledging that they needed to be admitted within 2 weeks of hospitalization. Since treatment avoidance is associated with poor outcome, these findings suggest a need for studies assessing the long-term outcome and ethics of pressuring patients with eating disorders into treatment.

Adolescent↗

PubMed2006

First-degree relative history of alcoholism in eating disorder inpatients: relationship to eating and substance use psychopathology.

OBJECTIVE: We examined the influence of family history of alcoholism on the presentation and course of inpatients with eating disorders (ED) by comparing ED behaviors, substance abuse behaviors, and psychopathology of patients with alcoholic first-degree relatives (AFDR+) to those without alcoholic first-degree relatives (AFDR-). METHOD: Female inpatients admitted to a specialty eating disorders service completed demographic, family history, behavioral, and psychological questionnaires (N=217). Body mass index (BMI) at admission and discharge, length of stay, and rates of weight gain were calculated. RESULTS: AFDR+ participants did not differ from AFDR- participants diagnostically, but AFDR+ participants did report higher lifetime frequencies of several ED and substance abuse behaviors. Measures of ED psychopathology and personality vulnerability were also elevated in the AFDR+ group. DISCUSSION: ED inpatients with a first-degree family history of alcoholism demonstrate increased psychopathology in eating behavior, substance use, and personality vulnerability domains. While the genetic diathesis for alcoholism is likely distinct from that for eating disorders, these findings suggest that first-degree relative history of alcoholism may nevertheless exert a negative influence on eating disorder behaviors.

Adolescent↗

PubMed2006

Development of the eating disorder recovery self-efficacy questionnaire.

OBJECTIVE: The purpose of the current investigation was to develop and validate the Eating Disorder Recovery Self-Efficacy Questionnaire (EDRSQ), a self-report measure of self-efficacy to recover from an eating disorder. METHOD: Participants were 116 female patients with anorexia nervosa, bulimia nervosa, or a subthreshold eating disorder treated at an eating disorder clinic. Patients completed the EDRSQ and measures of eating disorder symptoms and depression. RESULTS: The EDRSQ contains two internally consistent factors, Normative Eating Self-Efficacy and Body Image Self-Efficacy. Moderate to large correlations between EDRSQ subscales and measures of eating disorder pathology support the convergent validity of the EDRSQ. The EDRSQ demonstrates theoretically consistent relations with constructs that are related to but distinct from self-efficacy. Discriminant validity is reflected in small correlations between EDRSQ subscales and measures of general psychological correlates of disordered eating. CONCLUSION: The EDRSQ is a psychometrically sound measure to assess self-efficacy in patients with a range of eating disorder diagnoses.

Adolescent↗

PubMed2006

The reliability and validity of the Perceived Stigmatization Questionnaire (PSQ) and the Social Comfort Questionnaire (SCQ) among an adult burn survivor sample.

In this study, 361 adult burn survivors completed the Perceived Stigmatization Questionnaire (PSQ), the Social Comfort Questionnaire (SCQ), and other measures. Both the PSQ and SCQ had good internal consistency indices. Factor analysis of the PSQ yielded 3 factors (absence of friendly behavior, confused/staring behavior, and hostile behavior). The SCQ had 1 factor. Conjoint factor analysis with measures of related constructs (body esteem, body-esteem importance, depression, social support) suggested that PSQ and SCQ measure distinct constructs. Correlations with the related psychosocial constructs and burn characteristics suggested the PSQ and SCQ have good convergent and discriminant validity. Limitations of the study are discussed.

Adult↗

PubMed2004

The sociocultural attitudes towards appearance scale-3 (SATAQ-3): development and validation.

OBJECTIVE: The goal of this investigation was to develop and validate a revision of a widely used measure of societal influences on body image and eating disturbances-the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ). METHOD: Two independent samples of college females completed a revision and extension of the SATAQ and factor analyses were conducted to determine the underlying structure of the revised scale. RESULTS: Factor analyses indicated two distinct internalization factors: one appeared to reflect a generic media influence related to TV, magazines, and movies. A second factor clearly reflected internalization of athletic and sports figures. Two other factors, reflecting media pressures and media as an informational source, also emerged. Another widely used measure of thin-ideal internalization, the Ideal Body Internalization Scale-Revised (IBIS-R), was included in factor analyses to determine its empirical relationship with the revised SATAQ. None of the IBIS-R items loaded with any of the internalization items or items reflective of media pressures or information. Instead, the IBIS-R appeared to tap into an awareness of appearance norms dimension. The SATAQ-3 subscales had excellent convergent validity with measures of body image and eating disturbance. Eating-disturbed and eating-disordered samples had higher scores on SATAQ-3 subscales than a control sample. DISCUSSION: The SATAQ-3 measures multiple aspects of a societal influence and should prove useful for basic risk factor work as well as for gauging the efficacy of prevention and treatment programs.

Adolescent↗

PubMed2004

Chewing and spitting in eating disorders and its relationship to binge eating.

OBJECTIVE: This study examined (i) the frequency of chewing and spitting and (ii) its association with other pathological eating behaviors in eating-disordered inpatients. We hypothesized a positive association between chewing and spitting and binge eating given the phenomenological similarities between these disordered eating behaviors. METHOD: Frequent chewers/spitters were compared with those who did not regularly engage in this behavior with regard to diagnosis, psychometric test results, and associated eating pathology. RESULTS: Chewing and spitting was not associated with elevated bingeing. Rather, frequent chewers/spitters exhibited higher levels of restrictive eating behaviors and the behavior was more prevalent in younger patients. DISCUSSION: Contrary to our predictions, chewing and spitting is more closely associated with restrictive than with binge behaviors. This suggests that most individuals chew and spit small portions of food. The behavior is frequent, occurs across diagnostic groups, and may be associated with greater psychopathology. Future studies should clarify the amount of food consumed during chew/spit episodes and the presence of a sense of loss of control.

Adult↗

PubMed2004

Psychological factors in pelvic/urogenital pain: the influence of site of pain versus sex.

Chronic pelvic pain (CPP), a fairly common gynecological complaint in women, has been associated with multiple psychological sequelae, including depression and somatization. Previous work has compared these patients to gynecological controls and women with headache, but has failed to include male comparison groups with a comparable site of chronic pain. In order to test possible sex and pain site differences, the present study compared 22 women with CPP, 22 men with either penile or testicular pain, 22 women with low back pain and 28 men with low back pain referred for a psychological evaluation as part of multidisciplinary pain treatment. Depression, coping, pain intensity and interference were assessed. Two-way analyses of variance (sex by pain site) were conducted to determine if there were group differences on demographic variables and medical history. Pain duration, age, and pain severity differed among the groups and were entered as covariates in hierarchical regression analyses designed to identify predictors of adjustment and pain coping. Sex and pain site did not contribute independently to the prediction of depressive symptoms. Pain site predicted physical functioning with low back pain patients reporting greater pain-related interference. Similar findings were demonstrated for coping. A variety of pain-coping strategies, including catastrophizing, were more frequently utilized by low back pain patients, regardless of sex. In the present study, pain severity and pain site explained more variance in depressive symptoms, physical functioning, and pain-coping than sex.

Activities of Daily Living↗

PubMed2003

Psychologic factors in scleroderma.

CB interventions have been shown to reduce pain and improve psychosocial functioning in patients who have chronic illnesses, particularly chronically painful rheumatologic syndromes. These interventions are typically administered by specially trained professionals and are conducted during weekly individual or group sessions. When focused on pain and chronic illness, these interventions seem to have, at best, small effects on depression. Data from the headache literature and recent data about patients who have dental/facial pain indicate that minimal-contact CB therapy, the combination of some professional contact with audiotaped and written materials, may reduce pain in many patients, but the impact on functioning is less clear. Future studies should examine the impact of CB interventions on pain, depression, concerns about disfigurement, and physical and psychosocial functioning in scleroderma. Such knowledge is necessary for the optimal care of persons who have this debilitating illness. Although complicated, the advent of disease-specific interventions that are administered by way of the Internet may prove particularly useful in a rare illness, such as scleroderma. Psychologic factors with demonstrated relevance to scleroderma include pain, depression, and distress about disfigurement, physical function, and social function. Although these dimensions of quality of life are interrelated, pain, depression, and distress about disfigurement are common and may respond to psychologic interventions.

Adaptation, Psychological↗

PubMed2003

Body image dissatisfaction among women with scleroderma: extent and relationship to psychosocial function.

Body image dissatisfaction and its relationship to psychosocial function were investigated in 127 women with scleroderma Results indicated elevated body image dissatisfaction, with participants reporting higher levels than a sample of patients with severe burn injuries. Age, skin tightening above the elbows, and functional disability were related to heightened body image dissatisfaction, suggesting that younger patients with more severe disease may be at greatest risk for developing body image concerns. Path analysis revealed that depression mediated the relationship between body image dissatisfaction and psychosocial function. Results suggest that body image dissatisfaction is a significant concern in women with scleroderma and should be assessed routinely. Early identification and treatment of body image dissatisfaction may help prevent the development of depression and psychosocial impairment in this population.

Adaptation, Psychological↗

PubMed2002

The impact of pain and symptoms of depression in scleroderma.

Systemic sclerosis (scleroderma) is a rare connective tissue disease that can affect multiple organ systems. Case reports and small treatment studies suggest that pain is significant in scleroderma, but few data speak of the frequency or impact of pain. This study sought to determine the frequency and impact of pain, symptoms of depression, and social network characteristics on physical functioning and social adjustment in patients with scleroderma. One hundred and forty-two scleroderma patients completed measures of pain, depressive symptoms, social network characteristics, physical functioning, and social adjustment. Sixty-three percent reported at least mild pain and 50% reported at least mild levels of depressive symptomatology. Hierarchical regression analyses revealed that pain, depressive symptoms, and employment status (disabled/unemployed vs. not) were significant, independent predictors of physical functioning, together accounting for 37% of the total variance. Pain was the single strongest predictor of physical function, accounting for 20% of the variance. Depressive symptoms, physical functioning, diversity of social network, and employment status were significant independent predictors of social adjustment, together accounting for 63% of the variance. Depressive symptoms were the single strongest predictor of social adjustment, accounting for 26% of the variance. The effects of pain and physical function on social adjustment became non-significant when depressive symptoms were entered into the model, suggesting that symptoms of depression mediate the effect of pain and physical function on social adjustment. These findings indicate that pain is common in scleroderma and that pain and depressive symptoms are significant determinants of physical functioning and social adjustment, two important components of health-related quality of life. Increased attention to effective management of pain and symptoms of depression in scleroderma will likely lead to improved functioning and quality of life.

Adult↗

PubMed2002

Coping with body image changes following a disfiguring burn injury.

The influence of emotion-focused coping on distress following disfiguring injury was examined. Two types of emotion-focused coping (i.e., venting emotions vs. mental disengagement) were assessed in 78 patients with burn injury at baseline during acute hospitalization. Body image dissatisfaction (BID) was assessed 1 week and 2 months following discharge. Use at baseline of both venting emotions and mental disengagement, compared with use of only one or neither of these coping methods, was associated at the 2-month postdischarge follow-up with significantly higher BID related to nonfacial aspects of appearance and with a greater negative social impact of disfigurement. D. M. Wegner's (1994) theoretical model of mental control and a proposed motivational analysis are used to interpret these findings.

Adaptation, Psychological↗

PubMed1998

Pain coping strategies predict perceived control over pain.

Perceptions of control over pain and specific pain coping strategies are associated with a number of positive outcomes in patients with chronic pain conditions. Transactional models of stress have emphasized coping as a process that is both determined by, and influences appraisals of control. While perceptions of control and coping efforts are associated with better adjustment, little is known about the specific coping strategies that contribute to perceptions that pain is controllable. One hundred and ninety-five (65% female) individuals with chronic pain conditions admitted to an inpatient unit completed the Multidimensional Pain Inventory, the Survey of Pain Attitudes and the Coping Strategies Questionnaire. Stepwise multiple regression analyses were used to predict perceived pain control from measures of pain severity and coping. After controlling for pain severity and education, coping self-statements and reinterpreting pain sensations predicted greater perceptions of control over pain, whereas ignoring pain sensations predicted lower perceptions of control over pain. The coping strategies did not interact with pain severity in predicting perceptions of control. Coping flexibility, or the number of pain coping strategies reported at a high frequency, also predicted perceptions of control over pain and did not interact with pain severity. The present findings suggest that, regardless of pain severity, the use of specific cognitive pain coping strategies may increase perceptions of control over pain. Since the existing coping literature largely identifies maladaptive pain coping strategies, it is especially critical to establish which pain coping strategies are adaptive. Specific cognitive strategies, particularly coping self statements, are important components for cognitive-behavioral interventions for chronic pain management. Future research will need to determine whether other adaptive cognitive strategies such as reinterpreting pain sensations can be increased with cognitive interventions, since this strategy is infrequently used.

Adaptation, Psychological↗

PubMed1997

The urogenital and rectal pain syndromes.

Pain syndromes of the urogenital and rectal area are well described but poorly understood and underrecognized focal pain syndromes. They include vulvodynia, orchialgia, urethral syndrome, penile pain, prostatodynia, coccygodynia, perineal pain, proctodynia and proctalgia fugax. The etiology of these focal pain syndromes is not known. A specific secondary cause can be identified in a minority of patients, but most often the examination and work-up remain unrevealing. Although these patients are often depressed, rarely are these pain syndromes the only manifestation of a psychiatric disease. This review article presents an overview of the neuroanatomy of the pelvis, which is a prerequisite to trying to understand the chronic pain syndromes in this region. We then discuss the clinical presentation, etiology and differential diagnosis of chronic pain syndromes of the urogenital and rectal area and review treatment options. The current knowledge of the psychological aspects of these pain syndromes is reviewed. Patients presenting with these pain syndromes are best assessed and treated using a multidisciplinary approach. Currently available treatment options are empirical only. Although cures are uncommon, some pain relief can be provided to almost all patients using a multidisciplinary approach including pain medications, local treatment regimens, physical therapy and psychological support, while exercising caution toward invasive and irreversible therapeutic procedures. Better knowledge of the underlying pathophysioloigical mechanisms of the urogenital and rectal pain syndromes is needed to allow investigators to develop treatment strategies, specifically targeted against the pathophysiological mechanism.

Chronic Disease↗