Biomedical subjects

Rachel Bryant-Waugh

Publications and source records attributed to Rachel Bryant-Waugh.

7 recordsLinked to original sources

PubMed2006

An investigation into the psychometric properties of the Stirling Eating Disorder Scales.

The Stirling Eating Disorder Scales (SEDS) are widely used in clinical practice, however evidence regarding the internal consistency and validity of the measure is limited. The aim of this study was to investigate the psychometric properties of the SEDS in a mixed eating disorder population. The SEDS and the Eating Disorder Examination (EDE) were administered to 241 consecutive patients attending an adult out-patient eating disorder service in the UK. The internal consistency of the overall SEDS was good, but there was variation in the internal consistency of the individual subscales. There were differences across diagnosis for all SEDS subscales, and some significant correlations were found between the EDE and SEDS subscales. It was not possible to replicate the derivation of the original SEDS subscales using a principal components analysis (PCA); further analysis was conducted on the new subscales that were identified. It is suggested that information obtained from the administration of the SEDS should be interpreted with caution, and also that further exploration of the psychometric properties of the SEDS is warranted.

Adult↗

PubMed2006

Misuse of laxatives among adult outpatients with eating disorders: prevalence and profiles.

OBJECTIVE: The current study investigated the prevalence of laxative misuse among adult outpatients with eating disorders, distinguished demographic and psychobehavioral profiles of laxative misusers, identified specific predictors of laxative misuse, and explored whether prevalence rates and psychobehavioral profiles differ across eating disorder diagnoses. METHOD: Data were collected for 201 consecutive patients. Laxative misusers and nonmisusers were compared on demographic variables, measures of eating-related and weight-related behaviors and cognitions, and general psychopathology. RESULTS: Fifty-three (26.4%) patients had misused laxatives in the month before assessment. Laxative misusers scored significantly higher than nonmisusers on measures of anorexic behaviors and cognitions, restraint, and weight and shape concerns. They also displayed higher levels of depression and self-directed hostility. Laxative misuse was specifically predicted by anorexic behaviors and depression. Across diagnoses, proportions of misusers versus nonmisusers were similar. CONCLUSION: Laxative misuse remains prevalent among adult outpatients and is associated with increased severity of clinical presentation, regardless of the eating disorder diagnosis.

Adolescent↗

PubMed2006

Pathways to recovery: promoting change within a developmental-systemic framework.

This article describes a format for the process of achieving therapeutic change through structured individual sessions with adolescents or adults with eating disorders. It is a model for change based on three separate existing theoretical or conceptual strands: Developmental theory; the application of systems theory and cybernetics to clinical practice; and feminist ideology. It was developed as a pragmatic, clinician-friendly model that could be successfully used by therapists from different disciplines, and is referred to here as developmental-systemic-feminist therapy or individual developmental-systemic therapy. Change in this context is defined as the overt and measurable alteration in feelings, thoughts and behaviours of the participant(s) over the course of treatment. The article provides an overview of the treatment model and outlines the five steps used to achieve change (explore; understand; accept; challenge; change). Essential components of the therapist's stance, skills and knowledge are described, followed by a discussion of the structure and content of sessions in different stages of the therapy. Finally, clinical examples are given to illustrate the clinical use of this model in young patients with eating disorders.

Adolescent↗

PubMed2005

Maternal core beliefs and children's feeding problems.

BACKGROUND: Although maternal mental health problems have been implicated in the exacerbation of childhood feeding difficulties, little research has assessed the contribution of broader maternal cognitions to these problems. The current study examined gender differences in the relationships between mothers' core beliefs and children's feeding problems. METHODS: One hundred and three mothers of girls and 93 mothers of boys (age range, 7-64 months) completed the Young Schema Questionnaire and the Child Feeding Assessment Questionnaire. RESULTS: While controlling for child age, a clear link between maternal core beliefs and perceived feeding difficulties emerged for mothers of girls. In particular, abandonment, failure to achieve, dependence and incompetence, enmeshment and defectiveness, and shame beliefs were associated with increased reports of feeding problems in girls. In contrast, emotional deprivation and subjugation beliefs were associated with maternal reports of food fussiness and food refusal in boys. CONCLUSIONS: There appears to be a clear role for maternal core beliefs in the reporting of feeding difficulties in children, and the specificity of these links differs depending on the gender of the child. Further research is required to establish the direction of causality and the specificity of these relationships.

Attitude to Health↗

PubMed2005

Family physician consultation patterns indicate high risk for early-onset anorexia nervosa.

OBJECTIVE: There is often a delay in the recognition of early-onset anorexia nervosa. The current study aimed to determine whether there are specific patterns in the frequency and content of family physician consultations that might predict its onset. METHOD: Lifetime number and type of family physician consultations were recorded for three groups: (a) an index group comprising 19 girls with anorexia nervosa, onset under 14; (b) a clinical control group comprising 19 girls with an emotional disorder; and (c) a nonclinical group comprising 19 girls with no history of mental health problems. RESULTS: Both clinical groups had an elevated number of consultations, particularly in the 5 years before diagnosis. The index group had a significantly higher number of eating, weight, and shape consultations (especially in the year before diagnosis), whereas the clinical control group had a greater number of psychological consultations. CONCLUSION: A single consultation about eating behaviour or weight and shape concerns is a strong predictor of the subsequent emergence of anorexia nervosa.

Adolescent↗

PubMed2005

Reliability and validity of the child version of the Eating Disorder Examination: a preliminary investigation.

OBJECTIVE: The Eating Disorder Examination (EDE) is a reliable and valid semistructured interview that measures the specific psychopathology of anorexia nervosa (AN) and bulimia nervosa. The current study aims to investigate the psychometric properties of the child adaptation of the EDE (ChEDE 12.0). METHOD: The ChEDE was administered to 15 children with AN, 15 children with other clinical eating disturbances, and two groups of 15 age-matched controls. The groups were compared using a two-sample matched groups design. RESULTS: Alpha coefficients for each of the ChEDE subscales indicated a high degree of internal consistency, and interrater reliability was found to be high (r = .91 to r = 1.00). The subscale scores of the AN group were significantly higher than those of the other groups, whereas the other eating disturbance group did not differ from its control group. DISCUSSION: The ChEDE differentiates children with AN from children with other forms of clinical eating disturbance and control children.

Adolescent↗

PubMed2004

Management of child and adolescent eating disorders: the current evidence base and future directions.

Although eating disorders in children and adolescents remain a serious cause of morbidity and mortality, the evidence base for effective interventions is surprisingly weak. The adult literature is growing steadily, but this is mainly with regard to psychological therapies for bulimia nervosa and to some extent in the field of pharmacotherapy. This review summarises the recent research literature covering management in three areas, namely physical management, psychological therapies, and service issues, and identifies prognostic variables. Findings from the adult literature are presented where there is good reason to believe that these might be applied to younger patients. Evidence-based good practice recommendations from published clinical guidelines are also discussed. Suggestions for future research are made, focusing on 1) the need for trials of psychological therapies in anorexia nervosa, 2) applications of evidence-based treatments for adult bulimia nervosa to the treatment of adolescents, and 3) clarification of the benefits and costs of different service models.

Adolescent↗