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Biomedical subjects

S Touyz

Publications and source records attributed to S Touyz.

12 recordsLinked to original sources
PubMed2005

Coercion in the treatment of anorexia nervosa: clinical, ethical and legal implications.

Because of its high mortality and treatment resistence, clinicians sometimes invoke the law in aid of retaining their most acutely ill-patients in treatment or re-feeding programs. Depending on the jurisdiction, various laws, including mental health and adult guardianship laws, have been invoked to achieve this objective (Carney, Tait, Saunders, Touyz & Beumont, 2003). Until recently, little was known about the therapeutic impact of coercion on patients (Saunders, 2001, Carney & Saunders 2003), or the relative advantages of different avenues of coercion (Carney, Saunders, Tait, Touyz & Ingvarson 2004). Most obscure of all, however, has been our understanding of the factors influencing clinical decisions within specialist anorexia treatment units regarding which in-patients will be selected for coerced treatment. This paper reports legal and ethical implications of findings from analysis of data gathered from a major Australian specialist anorexia treatment facility over nearly 5 years.

Anorexia Nervosa↗
PubMed2004

Negative mood-induced overeating in obese binge eaters: an experimental study.

OBJECTIVES: To test the hypotheses that induction of negative mood in obese binge eaters would increase food intake, and that this would be greatest in those who were highly restrained. DESIGN: Experimental manipulation of mood (neutral vs sad film) prior to the presentation of food in a taste test. PARTICIPANTS: A total of 40 obese female binge eaters (41.7 y, mean BMI=40.2 kg/m(2)). MEASURES: Visual analogue assessment of mood and hunger motivation, dietary restraint (Dutch Eating Behaviour Questionnaire), and food intake. RESULTS: Exposure to the sad film resulted in a significant decrease in mood for both restrained and unrestrained participants. Those in the negative mood condition ate significantly more food, and the restrained eaters consumed the most. However, the expected restraint by mood interaction just failed to reach significance (P=0.06) CONCLUSIONS: The salience of negative mood in promoting overeating was confirmed. Conversely, dietary restraint had no significant impact on food intake. Further experimental work on binge eating in this group would be of value in clarifying the role of dieting and informing treatment approaches.

Adult↗
PubMed2001

Altered energy metabolism in anorexia nervosa.

Optimal nutritional rehabilitation of anorexia nervosa requires more information concerning actual energy and substrate requirements. To this end, indirect calorimetry was performed in female patients (n=34, age 20.9+/-1.2 yr, body mass index [BMI] 15.6+/-0.2 kg/m(2); mean+/-SEM) soon after commencement of refeeding and at the time of discharge from hospital (n=18, BMI 19.0+/-0.3 kg/m(2)). Healthy female controls (n=18, age 24.6+/-1.3 yr, BMI 21.6+/-0.6 kg/m(2)) were also tested. Resting energy expenditure (REE) and respiratory quotient (RQ) were measured in the fasting state, followed by diet-induced thermogenesis (DIT) and RQ over a 4 h period following a 100 g oral glucose load. Compared with post-refeeding patients and controls, pre-refeeding patients had a high basal RQ and a low REE, with a paradoxically higher DIT (13.2+/-0.9% of REE vs. 8.3+/-1.2% and 8.6+/-0.9% in post-refeeding patients and controls, respectively). RQ values in pre-refeeding patients exceeded unity following the glucose load, probably reflecting net lipogenesis, whereas in the post-refeeding patients, post-glucose RQ was similar to that of controls, suggesting premature curtailment of lipogenesis. These data demonstrate energy wasting in emaciated patients with anorexia nervosa. Biological repair processes could account for disproportionate energy loss early in refeeding and there may be some later impediment to full restoration of fat stores.

Adolescent↗
PubMed2000

The effect of body dissatisfaction on women's perceptions of female celebrities.

OBJECTIVE: Research suggests that media exposure causes some women to feel heightened dissatisfaction with their body shape. This study attempts to determine which women are effected as such, by investigating how women feel about their own bodies and how this effects their perceptions of female celebrities in the media. METHOD: Undergraduate females (n = 116) were shown one accurate and six distorted photographs of thin and heavy female celebrities. Each distorted photograph made the celebrity appear thinner or heavier than actuality. Participants chose which photograph portrayed each celebrity's true body shape. Body shape concerns were measured by the Body Shape Questionnaire. RESULTS: Women concerned about their body shape judged thin celebrities as thinner than actuality, whereas unconcerned women judged them accurately. Both groups judged heavy celebrities as heavier than actuality. DISCUSSION: Results suggest certain women are effected by media exposure due to their own perception of females in the media. Prevention strategies, and the media's role in body dissatisfaction and dieting disorders, are discussed.

Adolescent↗
PubMed2000

Development of an instrument to assess readiness to recover in anorexia nervosa.

OBJECTIVE: The degree to which patients with anorexia nervosa demonstrate readiness to recover from their illness has received scant theoretical or empirical attention. Investigating the prevalence and degree of amotivation for recovery in anorexia nervosa, its role in outcome, and the effectiveness of interventions designed to enhance readiness to recover necessitates the existence of a reliable and valid measure of motivational issues relevant to the disorder. The present study aimed to develop and evaluate an instrument for assessing readiness to recover in anorexia nervosa, namely, the Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ), a 23-item self-report questionnaire based on Prochaska and DiClemente's stages of change model. METHOD: Seventy-one inpatients with anorexia nervosa participated in the study. On several occasions during their admission, participants completed the ANSOCQ as well as questionnaires assessing readiness to recover, anorexic symptomatology, general distress, and social desirability. RESULTS: The ANSOCQ demonstrated good internal consistency (.90) and 1-week test-retest reliability (.89). Various aspects of validity were also supported, such as significant relationships with other instruments assessing readiness to recover and the prediction of weight gain during different periods of treatment. DISCUSSION: The results suggest that the ANSOCQ is a psychometrically sound instrument that may prove useful in investigating the role of readiness to recover in anorexia nervosa.

Adolescent↗
PubMed1995

The theme of death in the French and German literature on eating disorders.

It is not widely appreciated in the English-speaking world that a number of articles written in French and German do address the role played by death preoccupations and concerns in the development and maintenance of eating disorders, particularly anorexia nervosa. In previous published articles these important "hidden" threads have been highlighted in examining in some detail, the writings of the German authors Binswanger, Von Weizsäcker, and Thomä. In this article, the writings of other German authors are also briefly reviewed as well as the French authors Bensoussan, Fouraste, Raimbault, and Thouzery-Loras. Implications and issues are posed for both the researchers and clinicians alike contributing to the literature in English on eating disorders, who do not necessarily embrace these themes in therapy and who may not reflect their significance to theory in the literature itself.

Anorexia Nervosa↗
PubMed1994

Anorexia nervosa in an adolescent with early profound deafness.

This paper reports a case of anorexia nervosa in a 15-year-old schoolgirl who had been profoundly deaf since birth. She was admitted to a specialized eating disorders unit following a dramatic reduction in her weight. Her deafness and limited communication skills posed significant problems with regard to her overall management on the unit. Her clinical presentation and difficulties in management are presented.

Adolescent↗
PubMed1993

Cognitive processes in dieting disorders.

This study is an empirical investigation of the prevailing notion that dieting disorder patients have more dysfunctional cognitions and cognitive styles than the nonclinical population. Groups of anorexics, bulimics, normal restrainers, and normal nonrestrainers completed three questionnaires and two repertory grids. Overall, the data supported a cognitive model of dieting disorders. Patients exhibited a lack of awareness of the role played by inner sensations in regulating weight and eating behavior, and emphasized black and white rules instead. Anorexic patients tended to evaluate self-worth almost entirely in terms of self-control. Both patient groups evidenced extreme negativity in their views of themselves, but anorexics showed a particularly severe sense of self-isolation. Unlike bulimics, they extended a tendency to think in absolute terms from the area of eating to the rest of their lives. Thus, the psychopathology of the anorexic patient group appeared more severe than that of bulimics.

Adult↗
PubMed1993

Themes of death: Helmut Thomä's "Anorexia nervosa" (1967)--a research note.

In the recent literature on eating disorders, little attention is usually given to the possible role played by heightened death fears and anxieties and failed death transcendence in the dynamics of patients who suffer from anorexia and bulimia nervosa. For reasons that remain unclear, early texts and articles in the literature do address death themes, particularly as they are discernible from patients' dreams and nightmares. Thomä's 1967 text Anorexia Nervosa may be interpreted as giving further illustration to this thesis.

Adult↗
PubMed1992

The emergence of clinical psychology departments in Australian teaching hospitals.

Over recent years, clinical psychological services have diversified within the health sector, leading to a breakdown in the traditional nexus between clinical psychology and psychiatry, and to the emergence of the interdisciplinary field of behavioral medicine. From their earlier limited role as providers of psychometric assessments in educational and psychiatric hospital settings, clinical psychologists now provide a wide range of therapeutic services and research skills to general hospitals, universities, community health centres, and the private sector. This evolving trend has significant implications for the future structure and direction of clinical practices in clinical psychology, psychiatry and medicine.

Adaptation, Psychological↗
PubMed1989

Ganser syndrome in a 10 year old boy--an 8 year follow up.

A case of pseudodementia in a 10 year old boy was first reported in 1981. When reviewed 8 years after initial presentation, his symptoms were largely unchanged. The case continues to be complicated by claims for compensation and a successful appeal against the initial compensation judgment.

Amnesia↗