Biomedical subjects

S R Sunday

Publications and source records attributed to S R Sunday.

14 recordsLinked to original sources

PubMed1996

Micro- and macroanalyses of patterns within a meal in anorexia and bulimia nervosa.

Hospitalized women with anorexia nervosa and/or bulimia nervosa and dietarily restrained and unrestrained, clinically normal women were provided with a multi-item breakfast meal. Eating patterns and hunger and satiety ratings were assessed. Subjects were offered three foods which varied in fat and carbohydrate contents. Anorectic-restrictors differed most from the control subjects: they had a longer meal duration, a slower overall rate of eating, more frequent pauses during the meal, and more short bouts of eating. They also displayed abnormal ratings of hunger and satiety: they were generally less hungry, had less urge to eat, and were more full than controls of bulimics. Both anorectic and bulimic patients showed more variability in total energy intake than did the controls. Patients usually displayed one of two patterns - either severe restriction or overeating. Abnormal hunger and satiety patterns indicating confusion typified the responses of bulimics; additionally, they showed more urge to eat in the post-meal period than did the controls. A higher proportion of fat in the initial part of the breakfast was related to a larger meal size for the bulimics. It is suggested that these techniques may be useful in evaluating the outcome of treatment for eating disorder patients.

Anorexia Nervosa↗

PubMed1995

The Yale-Brown-Cornell Eating Disorder Scale: a new scale to assess eating disorder symptomatology.

Anorectic and bulimic patients (n = 100) were interviewed using the Yale-Brown-Cornell Eating Disorder Scale (YBC-EDS). All patients reported preoccupations and rituals related to their eating disorder ranging from mild to severe symptomatology, with mean scores in the moderate range. The preoccupations were more severe than the rituals; however, the rituals were still time-consuming, distressing, and interfered with functioning. Both preoccupations and rituals were largely ego syntonic. The YBC-EDS is an easy to administer interview which characterizes and quantifies preoccupations and rituals associated with eating disorders. It is useful both for research and clinical purposes.

Adaptation, Psychological↗

PubMed1995

Anorexia nervosa and bulimia nervosa in adolescence: effects of age and menstrual status on psychological variables.

OBJECTIVE: To compare, in adolescents and adults with anorexia nervosa and bulimia nervosa, eating disorder symptomatology and comorbid affective and anxiety states. METHOD: Two hundred fifty consecutive, female inpatients on an eating disorders unit were studied. They were given the Beck Depression Inventory; the Depression, Obsessive-Compulsive, Anxiety, and Phobic Anxiety scales from the Symptom Checklist 90; and the Eating Disorder Inventory. Patients were divided into categories based on age, diagnosis, and menstrual status. RESULTS: Onset of anorexia nervosa before age 14 and primary amenorrhea were associated with the greatest maturity fears during acute illness. For patients with restricting anorexia, adolescents aged 17 through 19 years had the highest drive for thinness compared to adolescents aged 13 through 16 years and adults. The lowest levels of depression and anxiety were seen in patients younger than age 14 with restricting anorexia. CONCLUSION: Overall, few psychological differences between adults and adolescents with eating disorders were found, with the exceptions of the youngest restricting anorectic patients at the time of treatment and both restricting and bulimic-anorectic patients who had a very early onset of their illness. Younger patients with acute anorexia nervosa may not require pharmacotherapy for anxiety and depression and may benefit from a focus on maturity fears in psychotherapy.

Adolescent↗

PubMed1994

Psychiatric comorbidity in patients with eating disorders.

The Structured Clinical Interview for DSM-III-R (SCID and SCID II) was administered to 105 eating disorder in-patients in order to examine rates of comorbid psychiatric disorders and the chronological sequence in which these disorders developed. Eighty-six patients, 81.9% of the sample, had Axis I diagnoses in addition to their eating disorder. Depression, anxiety and substance dependence were the most common comorbid diagnoses. Anorexic restrictors were significantly more likely than bulimics (all subtypes) to develop their eating disorder before other Axis I comorbid conditions. Personality disorders were common among the subjects; 69% met criteria for at least one personality disorder diagnosis. Of the 72 patients with personality disorders, 93% also had Axis I comorbidity. Patients with at least one personality disorder were significantly more likely to have an affective disorder or substance dependence than those with no personality disorder.

Adolescent↗

PubMed1992

Relationship of perceived macronutrient and caloric content to affective cognitions about food in eating-disordered, restrained, and unrestrained subjects.

Cognitive sets concerning food were examined in eating-disorder patients and in restrained and unrestrained control subjects. Subjects rated 38 common foods for preference, presence or absence of guilt and danger, preferred monthly frequency, and caloric, fat, and carbohydrate content. Cognitive ratings were examined based upon the individual's perceived amounts of calories and macronutrients. Hedonic ratings of foods perceived as high in fat or calories were different in patients with current or past anorexia and did not change with treatment. The fat-calorie aversions seen in these patients, therefore, appear to be stable trait characteristics of the disorder. Guilt and danger were perceived as separate constructs by unrestrained and restrained control subjects but not by patients. Perceived high amounts of calories or fat triggered stronger feelings of guilt and danger for restrained control subjects and patients (especially bulimic patients) as compared with unrestrained control subjects. The patients' expressions of guilt and danger improved with treatment.

Affect↗

PubMed1991

Temporal patterns of hunger and fullness ratings and related cognitions in anorexia and bulimia.

Hunger and fullness during an experimental liquid meal were evaluated by ratings in 84 eating-disordered patients, including three diagnostic subgroups, and in 19 controls who were normal in weight and eating healthily. Anorectic-restrictors had lower hunger ratings and higher fullness ratings than controls. The same tendency was present in anorectic-bulimics. These ratings were relatively unaffected by treatment. Anorectic-restrictors had longer meals than the anorectic-bulimics and normal-weight bulimics. The anorectic-restrictors also tended to eat more slowly than did the bulimic patients. These groups did not, however, differ in amount consumed. At the end of the experimental meal, the anorectic-bulimics were more preoccupied with thoughts of food and anorectic-restrictors had a lower urge to eat, as compared with the controls. Hunger and fullness ratings were negatively correlated for all diagnostic groups; however, these correlations were less pronounced for the eating disorder groups. The eating-disordered patients had predominantly "abnormal" patterns of hunger and fullness curves, indicating a confusion of these concepts.

Adult↗

PubMed1991

Serotonergic responsivity in eating disorders.

Evidence suggests that serotonin may play a role in the pathogenesis of eating disorders. In this ongoing study, serotonin-mediated physiological responses and whole-blood serotonin content are measured in young women with an eating disorder during the active phase of the illness and at the conclusion of inpatient treatment. The responsivity of central nervous system (CNS) serotonergic pathways is assessed by neuroendocrine challenge with a 60-mg oral dose of dl-fenfluramine, an indirect serotonin agonist, whereas the responsivity of the platelet serotonin2 (5-HT2) receptor complex is evaluated by measurement of the magnitude of serotonin-amplified platelet aggregation. Compared with normal controls, eating-disorder patients have exhibited a trend toward reduced prolactin responses to fenfluramine challenge at both the initial and followup assessments. Patients also have exhibited a substantially wider range of serotonin-amplified platelet aggregation responses than have controls; normal-weight bulimic patients have had significantly greater responses than both anorexic restrictors and normal subjects. These preliminary results suggest potential alterations in serotonin-mediated responses in eating-disorder patients that may vary with the diagnostic subgroup.

Adolescent↗

PubMed1990

Taste perceptions and hedonics in eating disorders.

Hedonic and intensity ratings of 20 dairy solutions, with varying levels of fat and sucrose, were obtained before and after treatment for anorectic-restrictors, anorectic-bulimics, normal-weight bulimics, and control subjects. There were no differences between diagnostic groups in ability to rate sweetness intensity; all subjects were able to correctly assess increasing sucrose concentration. During the pretreatment test, both bulimic groups showed elevated intensity ratings of lower fat solutions and solutions which contained no sugar as compared with the other two groups. These differences were not present after treatment. There were differences in hedonic ratings between the anorectic groups and the controls, which persisted even after treatment. Both groups of patients showed an aversion to high fat solutions; anorectic-restrictors also demonstrated an aversion to all solutions which contained no sugar. The stability of these hedonic profiles suggests that these responses may be trait characteristics of anorexia nervosa.

Adolescent↗

PubMed1987

Species differences in polysaccharide and sugar taste preferences.

This study compared the polysaccharide and sugar taste preferences of humans and four rodent species (laboratory rats, Rattus norvegicus; Golden Syrian hamsters, Mesocricetus auratus; Mongolian gerbils, Meriones unguiculatus; Egyptian spiny mice, Acomys cahirinus). In Experiment 1 human subjects rated the pleasantness, sweetness, and flavor intensity of polysaccharide (Polycose), sucrose, and maltose solutions at concentrations of 0.0125 M to 0.4 M, and 1% to 32% concentrations. At the higher molar concentrations Polycose was rated as less sweet and less pleasant than the sucrose and maltose solutions; there were no differences in the flavor intensity ratings. With the percent concentrations Polycose was rated as less sweet and less flavorable as the sucrose and maltose solutions; there were no reliable differences in the pleasantness ratings. In Experiment 2, the Polycose, sucrose, and maltose preferences of rats, hamsters, gerbils, and spiny mice were compared using 24 hr two-bottle tests (saccharide vs. water) at concentrations of 0.001 M, 0.005 M, 0.01 M, and 0.1 M. In general, the rats displayed stronger preferences for Polycose and maltose than did the other three species. In addition, the gerbils showed a stronger Polycose preference at the 0.1 M concentration than did the hamsters and spiny mice, and the spiny mice display a weaker preference for sucrose than did the other three species. Within species comparisons revealed that all four species displayed preferences for Polycose that were as strong or stronger than their preferences for sucrose and maltose. With only a few exceptions, male and female rodents did not differ in their saccharide preferences. Thus, while rats show the most robust Polycose preference of the four rodent species, all four species were attracted to the taste of polysaccharides. Humans, on the other hand, reported that Polycose solutions were unpleasant. The results suggest that rodents have taste receptors for starch-derived polysaccharides that humans lack.

Adult↗

PubMed1983

Palatability and meal patterns.

Investigations of palatability have often been confounded by nutritional, pharmacological or methodological problems. The present experiment examined the free-feeding meal patterns of two differentially preferred yet nutritionally equivalent diets. When the two diets were offered sequentially (Experiment 1), no differences were found in meal frequency, meal size, or meal duration. However, when the diets were offered simultaneously in Experiment 2, the preferred diet was consumed more frequently, in larger meals, and at a faster feeding rate than the less preferred diet. Further, the meal patterns in Experiment 2 of the preferred diet were identical with those found for both diets in Experiment 1. Therefore, the meal patterns of two diets with differing palatability depend upon the method of presentation with differences appearing when the diets are offered simultaneously but not when they are offered sequentially.

Animals↗

PubMedDate not supplied

Effects of depression and borderline personality traits on psychological state and eating disorder symptomatology.

The incidence of current or lifetime affective disorder and borderline personality characteristics were measured in bulimia nervosa patients. The relationship of these variables to the severity of eating disorder symptomatology (Eating Disorder Inventory [EDI]) and general psychiatric symptoms (Hopkins Symptom Checklist [SCL]) was examined. Categorical diagnostic assessments of affective disorder and borderline personality disorder (BPD) were made by Structured Clinical Interviews for DSM-III-R (SCID-I and -II). Affective disorder diagnosis (both current and lifetime) strongly influenced EDI and SCL profiles, while borderline personality characteristics had little influence. An understanding of the broad psychological symptomatology in bulimics requires the consideration of comorbid psychiatric illnesses, especially affective disorders.

Adult↗

PubMedDate not supplied

Seasonal patterns in eating disorder subgroups.

Patients with bulimia nervosa (BN) often have seasonal patterns of mood and appetite that compare with patterns seen in seasonal affective disorder (SAD). Seasonal patterns in other eating disorder (ED) subgroups have not been adequately described. We report on seasonal patterns in mood, weight, appetite, sleep, social activity, and energy in 154 consecutive admissions to an outpatient ED program: 60 patients with anorexia nervosa (AN), 31 with BN, 34 with a history of both AN and BN (AN/BN), and 29 with an ED not otherwise specified (ED-NOS). AN patients had significantly less seasonal variation overall than either bulimic subgroup, as measured by the global seasonality score (GSS) on the Seasonal Patterns Assessment Questionnaire (SPAQ). AN patients also showed less seasonal change in mood, weight, and energy than BN patients, and less variation in mood and appetite than AN/BN patients.

Adolescent↗

PubMedDate not supplied

The Yale-Brown-Cornell Eating Disorder Scale: development, use, reliability and validity.

Patients with eating disorders present with a wide range of eating-related preoccupations and or rituals. Yet, eating disorder assessments traditionally have measured a finite number of specific eating-disordered thoughts or actions. The current work presents a new instrument, the Yale-Brown-Cornell Eating Disorder Scale (YBC-EDS), that does not limit assessment to a particular set of eating-related concerns or behaviors. Rather, it assesses the severity of illness associated with an individual's unique symptomatology. Reliability and validity of this new, clinician-rated instrument was tested in two independent samples of DSM-III-R eating disorder patients. The YBC-EDS eight-item scale assessing severity of preoccupations and rituals, and a set of six provisional items for assessing motivation for change were both frequently endorsed and found to have excellent interrater reliability. Internal consistency was shown to be good for the set of eight core items and the set of six items related to motivation for change. The eight-item scale demonstrated aspects of convergent validity with other assessments of eating disorder symptomatology. The set of six provisional items for assessing motivation for change was inversely related to measures to diet restriction, drive for thinness, and body dissatisfaction. This paper presents the eight-item Yale-Brown-Cornell Eating Disorder Scale for assessing illness severity in eating-disordered patients with an extensive range of symptomatology. An accompanying set of six provisional items for assessing motivation for change are also presented. Initial findings showed excellent reliability and indications of validity for both the eight-item YBC-EDS and the set of six provisional items.

Adolescent↗

PubMedDate not supplied

A comparative analysis of Minnesota Multiphasic Personality Inventory profiles of anorexia nervosa at hospital admission, discharge, and 10-year follow-up.

The assessment of personality variables measured by the Minnesota Multiphasic Personality Inventory (MMPI), was compared in a sample of 52 female inpatients with anorexia nervosa at the time of hospitalization, discharge from hospital, and 10 years after treatment. Admission MMPI scores were significantly higher than scores both at discharge and 10 years later. There were no significant overall differences between discharge and follow-up evaluation. Discharge, but not admission, MMPI scores were positively correlated with 10-year follow-up study on seven of 10 clinical MMPI scales (all but hypochondriasis, masculinity/femininity, and hypomania). At follow-up evaluation, eating disorder poor outcome was associated with higher MMPI scores. There was no significant difference on admission MMPI scores between the four outcome groups; however, patients who recovered had a greater decrease in MMPI scores at the 10-year follow-up study compared with poor outcome patients. The long-term outcome of anorexia nervosa was largely unrelated to the severity of psychopathology during the acute phase of the illness. These results suggest that persistent personality features are best measured following treatment of acute symptomatology of anorexia nervosa.

Adult↗