Biomedical subjects

Tracey D Wade

Publications and source records attributed to Tracey D Wade.

At least 19 recordsLinked to original sources

PubMed2007

A retrospective comparison of purging type disorders: eating disorder not otherwise specified and bulimia nervosa.

OBJECTIVE: In light of recent research indicating the clinical significance of eating disorder not otherwise specified-purging only (EDNOS-P), differences between women with lifetime bulimia nervosa purging subtype (BN-P) and EDNOS-P were examined. METHOD: Three groups of women were examined, a control group (n = 684) and two groups with lifetime eating disorders: BN-P (n = 22), and EDNOS-P (n = 53). RESULTS: Women with lifetime BN-P were significantly more likely to use vomiting than women with EDNOS-P but the latter group relied more on laxative abuse. Compared with controls, women with both eating disorders had higher weight and shape concern, dietary restraint, lifetime major depression, and suicidality. The BN-P group had significantly higher eating concern, dietary restraint, and suicidality than the EDNOS-P group. CONCLUSION: In accordance with previous research examining women with current eating disorders, EDNOS-P is indicated to be clinically significant. On the whole, the pattern of results indicated that EDNOS-P lies somewhere between BN-P and healthy controls in its clinical significance.

Adult↗

PubMed2006

Shared genetic and environmental risk factors between undue influence of body shape and weight on self-evaluation and dimensions of perfectionism.

BACKGROUND: Theory and evidence strongly suggest that perfectionism may be a risk factor for eating disorders. The purpose of the current study was to investigate a model that would explain the relationship between the cognitive diagnostic criterion for both anorexia nervosa and bulimia nervosa, namely undue influence of body weight or shape on self-evaluation, and dimensions of perfectionism. The model of particular interest was the common cause model, which hypothesizes that the phenotypes are caused by the same underlying genetic and environmental risk factors. METHOD: Female twins (n=1002) from the Australian Twin Registry (ATR), aged 28 to 39 years, were interviewed using the Eating Disorder Examination (EDE). In addition, questions relating to the Equal Environment Assumption (EEA) and the Frost Multidimensional Perfectionism Scale, namely concern over mistakes (CM), personal standards (PS) and doubts about actions (DA), were assessed. RESULTS: There was no evidence of violation of the EEA for any of the four phenotypes. Univariate models showed all phenotypes to be influenced by both genetic and non-shared environmental action, where genetic estimates ranged from 25% to 39% of the variance. Multivariate analyses suggested the best explanation of covariation among the phenotypes was an independent pathways, rather than a common pathways, model. CONCLUSIONS: Undue influence of body weight or shape on self-evaluation shared about 10% of its sources of genetic and environmental variance with perfectionism, thus suggesting that a common cause model does not represent the best explanation of the relationship between perfectionism and this cognitive diagnostic criterion for eating disorders.

Adult↗

PubMed2006

The interaction of perfectionism, perceived weight status, and self-esteem to predict bulimic symptoms: the role of 'benign' perfectionism.

The present study sought to replicate an interactive model of global perfectionism, perceived weight status, and self-esteem in predicting bulimic symptom development in a sample of young women [Bardone-Cone, et al. (2006). Predicting bulimic symptoms: An interactive model of self-efficacy, perfectionism, and perceived weight status. Behaviour Research and Therapy, 44, 27-42; Vohs, K. D., et al. (1999). Perfectionism, perceived weight status, and self-esteem interact to predict bulimic symptoms: A model of bulimic symptom development. Journal of Abnormal Psychology, 108, 695-700; Vohs, K. D., et al. (2001). Perfectionism, body dissatisfaction, and self-esteem: An interactive model of bulimic symptom development. Journal of Social and Clinical Psychology, 20, 476-497]. The aim was to investigate the role of 'problematic' and 'benign' perfectionism within this model, using data from 95 female university students over a 3-month period. Contrary to hypotheses, multivariate analyses revealed a significant three-way interaction only between 'benign' perfectionism, perceived weight status and self-esteem in predicting change in bulimic symptoms over a 3-month period. The predictive effect of the interaction between 'benign' perfectionism and perceived weight status on bulimic symptoms was strongest for women with high self-esteem, for whom feeling overweight and having perfectionistic attitudes preceded increased bulimic symptoms. These findings suggest that high self-esteem is insufficient to protect against the development of bulimic symptoms when both the perception of oneself as being overweight, and high levels of perfectionistic standards, are present. It would appear that the role of perfectionism within the context of disordered eating is complex.

Adolescent↗

PubMed2006

Guided self-help versus pure self-help for perfectionism: a randomised controlled trial.

Perfectionism is known to be a risk factor for the development and maintenance of obsessive-compulsive (OC) and depressive symptoms. The purpose of the present study was to test the effectiveness of a cognitive-behavioural self-help therapy for perfectionism, and to examine the effect of such treatment on OC and depressive symptomatology. The study compares the effectiveness of guided self-help (GSH, n=24) with pure self-help (PSH, n=25) therapy. Both GSH and PSH were found to be effective in reducing perfectionism, and also in reducing OC and depressive symptomatology. Overall, participants in the GSH condition experienced greater symptom improvement than participants in the PSH condition, and treatment gains for both groups were largely maintained at 3-month follow-up. Twenty percent of PSH participants experienced clinically significant increases in depressive symptoms over the treatment and follow-up period (compared to 0% in the GSH condition), suggesting that PSH may be a less suitable strategy than GSH in treating this population. Overall, the findings suggest that self-help for perfectionism is effective in reducing OC and depressive symptomatology in non-clinical individuals, with GSH being superior to PSH.

Adult↗

PubMed2006

Psychological risk factors for increased post-operative length of hospital stay following coronary artery bypass graft surgery.

To date, researchers have examined the role of psychological factors in longer-term adaptation to coronary artery bypass graft surgery (CABG), but few have investigated the role of such factors in the immediate post-operative period. Thus, the current study examined psychological risk factors for increased post-operative length of hospital stay in 119 consecutive elective CABG patients (100 men and 19 women). When controlling for operative/post-operative factors, medical factors accounted for 24.5% of the variance. However, pre-operative psychological factors accounted for a further 4.4% of the variance, with increased depression and lower PTSD symptomatology identified as significant independent risk factors for longer post-operative length of hospital stay. Hence, while post-operative length of hospital stay is largely determined by medical factors, psychological factors also influence this outcome. Further research is required to replicate the current findings and to determine the mechanisms through which these variables may act.

Adult↗

PubMed2006

Use of latent profile analysis to identify eating disorder phenotypes in an adult Australian twin cohort.

CONTEXT: The relationships among the different eating disorders that exist in the community are poorly understood, especially for residual disorders in which bingeing or purging occurs in the absence of other behaviors. OBJECTIVE: To examine a community sample for the number of mutually exclusive weight and eating profiles. DESIGN: Data regarding lifetime eating disorder symptoms and weight range were submitted to a latent profile analysis. Profiles were compared regarding personality, current eating and weight, retrospectively reported life events, and lifetime depressive psychopathology. SETTING: Longitudinal study among female twins from the Australian Twin Registry in whom eating was assessed by a telephone interview. PARTICIPANTS: A community sample of 1002 twins (individuals) who had participated in earlier waves of data collection. MAIN OUTCOME MEASURES: Number and clinical character of latent profiles. RESULTS: The best fit was a 5-profile solution with women who were (1) of normal weight with few lifetime eating disorders (4.3%), (2) overweight (10.6% had a lifetime eating disorder), (3) underweight and generally had no eating disorders except for 5.3% who had restricting anorexia nervosa, (4) of low to normal weight (89.0% had a lifetime eating disorder), and (5) obese (37.0% had a lifetime eating disorder). Each profile contained more than 1 type of lifetime eating disorder except for the third profile. Women in the first and third profiles had the best functioning, with women in the fourth and fifth profiles having similarly poorer functioning. The women in the fourth group had a symptom profile distinctive from the other 4 groups in terms of severity; they were also more likely to have had lifetime major depression and suicidality. CONCLUSION: Lifetime weight ranges and the severity of eating disorder symptoms affected clustering more than the type of eating disorder symptom.

Adult↗

PubMed2006

Impact of interactive school-based media literacy lessons for reducing internalization of media ideals in young adolescent girls and boys.

OBJECTIVE: The primary objective of the current study was to examine the efficacy of single media literacy lessons in reducing media internalization in young adolescents. METHOD: Eleven classes of 237 students (100 girls and 137 boys; mean age = 13.79 years, SD = .42) randomly received 1 of 6 lessons. Eating disorder risk factors were assessed at baseline, and the Sociocultural Attitudes Towards Appearance Questionnaire-3 (SATAQ-3) was used to assess media internalization postintervention. RESULTS: At postintervention, boys had significantly lower SATAQ-3 scores on 4 of the 5 subscales (effect sizes = .42-.71), whereas girls had significantly lower scores on 1 subscale (effect size = .54). Higher baseline levels of dietary restraint, magazines bought/read, and perceived sociocultural pressure predicted smaller reductions in boys' scores, whereas depression predicted smaller reductions in girls' scores. CONCLUSION: The current study provides support that boys be included in eating disorder prevention programs and that media literacy may represent a promising prevention approach.

Adolescent↗

PubMed2006

Psychological risk factors for cardiac-related hospital readmission within 6 months of coronary artery bypass graft surgery.

OBJECTIVE: The objective of this study was to examine the psychological risk factors for cardiac-related readmission within 6 months of coronary artery bypass graft surgery (CABG). METHODS: Consecutive patients awaiting elective CABG (N=119; 100 males and 19 females), with a mean age of 63.3 years, completed a battery of psychosocial measures in a three-stage repeated-measures design. Relevant medical data were also extracted from patients' medical records 6 months postoperatively to allow for the examination of potential covariates. RESULTS: Two psychological variables, increased postoperative anxiety and increased preoperative depression, were identified as risk factors for cardiac-related readmission independent of the only significant covariate identified, cardiopulmonary bypass time. CONCLUSION: Anxiety in the immediate postoperative period and, to a lesser extent, preoperative depression are important determinants of health care utilization postdischarge. Further research to clarify the psychological factors that are predictive of readmission, and that attempt to determine both the underlying cause of readmissions and potential mechanisms through which psychological factors act is recommended. Such research may highlight potential factors to target in interventions and the best time at which to intervene.

Adult↗

PubMed2006

Prevalence and long-term course of lifetime eating disorders in an adult Australian twin cohort.

OBJECTIVE: Few studies exist that have examined the spectrum and natural long-term course of eating disturbance in the community. We examine the lifetime prevalence and long-term course of anorexia nervosa (AN), bulimia nervosa (BN) and eating disorder not otherwise specified (EDNOS) in an adult female twin population. METHOD: Female twins (n = 1002) from the Australian Twin Registry, aged 28-39 years, were assessed using the Eating Disorder Examination, revised to yield lifetime diagnostic information. For women with lifetime eating disorders, the assessment occurred, on average, 14.52 years (SD = 5.65) after onset of their disorder. RESULTS: In accordance with other community studies, we found a 1.9% lifetime prevalence of AN, with an additional 2.4% who met the criteria for 'partial AN' (absence of amenorrhea). Criteria for BN were met by 2.9% of the women, an additional 2.9% of women met criteria for binge eating disorder, while 5.3% met criteria for purging disorder unaccompanied by binge eating (EDNOS-p). Eleven (7%) of the women with lifetime eating disorders had a current eating disorder. Each diagnostic group continued to be differentiated by current eating pathology from women without lifetime eating disorders. Although approximately 75% of the women had a good outcome, less than 50% of each diagnostic group was asymptomatic. CONCLUSIONS: Eating disorders tend to improve over time often reaching subdiagnostic levels of severity, but only a minority of sufferers becomes asymptomatic. The DSM-IV diagnosis EDNOS needs to be considered in studies of the prevalence and course of eating disorders.

Adult↗

PubMed2006

A transdiagnostic approach to understanding eating disorders.

Categorical models dominate the eating disorder field, but the tandem use of categorical and dimensional models has been proposed. A transdiagnostic dimensional model, number of lifetime eating disorder behaviors (LEDB), was examined with respect to (1) its relationship to a variety of indicators of the individual's functioning, (2) the degree to which it was influenced by genetic and environmental risk factors, and (3) exposure to specific environmental risk factors. Data from self-report and interview from 1002 female twins (mean age = 34.91 years, SD = 2.09) were examined. While 15.4% women met criteria for a lifetime eating disorder, 29% had at least one LEDB. The dimensional measure provided an indicator of associated functioning, and was influenced primarily by the nonshared environment. The number of LEDB was associated with the degree of impaired functioning. This impairment was associated with conflict between parents and criticism from parents when growing up.

Adult↗

PubMed2006

Application of a chronic illness model as a means of understanding pre-operative psychological adjustment in coronary artery bypass graft patients.

OBJECTIVES: To increase understanding of the factors associated with pre-operative psychological adjustment in coronary artery bypass graft (CABG) patients by assessing the utility of a chronic illness model developed by Scharloo, Kaptein, Weinman, Willems, and Rooijmans (2000). DESIGN: A cross-sectional design was employed. METHOD: Elective CABG patients (N=119) completed self-report measures of illness representation, self-rated health, social support, coping methods, and pre-operative adjustment (depression and post-traumatic stress disorder (PTSD) symptomatology) an average of 30 days prior to surgery. Hierarchical multiple regression was used to assess the mediational relationships proposed by the chronic illness model. RESULTS: Five 3-variable mediational chains were assessed. In all instances, the results conformed to the relationships suggested by the chronic illness model where the strength of the relationship between the independent and dependent variables was reduced when the mediator variable was controlled. However, a significant reduction of this relationship was found in three of the five chains examined. The most rigorous support for the model occurred, where increased use of avoidance coping mediated the relationship between poorer self-rated health and increased PTSD symptomatology, and also where increased use of avoidance coping partially mediated the relationship between a more negative illness representation and increased PTSD symptomatology, and poorer self-rated health and increased depression. CONCLUSIONS: The chronic illness model of Scharloo and colleagues shows potential in explaining pre-operative adjustment in CABG patients. Longitudinal examination of the model is recommended.

Adaptation, Psychological↗

PubMed2005

The mediating effects of misinterpretation of intrusive thoughts on obsessive-compulsive symptoms.

Perfectionism and inflated responsibility have both been identified as risk factors for the development and maintenance of obsessive-compulsive (OC) symptoms. The aim of the present study was to test whether the relationships between these two variables and OC symptoms are mediated by the misinterpretation of intrusive thoughts (MIT). Three hundred and three university students completed the Frost Multidimensional Perfectionism Scale, the Maudsley Obsessional Compulsive Inventory, the Responsibility Attitude Scale, and the Responsibility Interpretations Questionnaire. MIT was found to partially mediate the relationship between responsibility attitudes and OC symptoms. MIT also partially mediated the relationship between concern over mistakes and OC symptoms, even after controlling for responsibility attitudes. Both concern over mistakes and responsibility attitudes were significant predictors of MIT and OC symptoms, but responsibility was the stronger predictor when all of the variables were included in the model. Clinical implications for the treatment of OCD are discussed.

Adolescent↗

PubMed2005

Executive functioning in anorexia nervosa: exploration of the role of obsessionality, depression and starvation.

Cognitive deficits related to executive functioning have been previously identified in anorexia nervosa (AN). Currently, there is limited knowledge about the degree to which other variables related to AN or executive function may influence the observed relationships. The present study examined three groups of participants, women with AN (n=22), and two control groups: women who were high in obessionality (n=20) and women who were low in obsessionality (n=21). Women reporting disordered eating over the previous 4 weeks were screened out of the control groups. Executive function was measured using the Wisconsin card sorting test (WCST) and the uses of common objects test (UCOT). In addition, depression, obsessionality and body mass index were measured. Initial analyses showed no significant differences between the groups on executive function, but moderate effect sizes were obtained for performance on UCOT total perseverations and WCST total trials. When controlling for either depression or obsessionality, the group differences on the UCOT total perseverations became significant and in the case of depression attained a large effect size. Both the AN and high obsessional groups showed significantly more perseverations than the low obsessional group. Depression appeared to suppress variance that was irrelevant to the prediction of perseverance thus enhancing the importance of group membership. It is recommended that variables strongly associated with AN be investigated in future research as this may clarify the relationship between AN and executive function.

Adolescent↗

PubMed2005

Predicting worries about health after breast cancer surgery.

Given the widespread worries about future health in women with breast cancer, it is important to understand the predictors of such fear so that possible avenues for intervention can be formulated. In this longitudinal study of 44 women who had undergone breast cancer surgery, we look at demographic variables, cancer and treatment related symptoms, and denial coping measured post-surgery and their ability to predict future health fears at 6-weeks and 12-weeks post-surgery. At both follow-up periods, around 1 in 5 women had strong worries about their future health, and post-surgery future health fears significantly predicted future health fears. In a hierarchical multiple regression, controlling for post-surgery health fears, future health fears at both follow-up periods were predicted only by denial coping. Cross-lag analyses suggested that these relationships were causal. Findings suggest that denial coping is a powerful predictor of future health fears, with this relationship growing stronger over time. Future research should investigate which interventions can decrease denial, and whether this then decreases health fears in the aftermath of breast cancer surgery.

Adult↗

PubMed2005

The impact of breast cancer on the lives of middle-aged women: results from the Australian longitudinal study of women's health.

This article investigated the impact of breast cancer (BC) in middle-aged Australian women (45-50 years). Two waves of data collected 2 years apart from a longitudinal survey of 12,177 women identified 3 groups: (a) 11,933 (98%) who reported never having had BC, (b) 181 (1.5%) who reported a diagnosis of BC at Time 1, and (c) 63 (0.5%) who reported onset of BC between Time 1 and Time 2. Repeated measures analysis of variance was used to compare the 3 groups. Women with recent onset of BC experienced significant changes across a range of functioning compared with the other 2 groups. Compared with women with no BC, women with longer established onset of BC had significantly worse health and social outcomes, but these were associated with small effect sizes. Both groups of women with BC reported less impact on mental and emotional health than on other areas of functioning.

Australia↗

PubMed2004

Sex influences on shared risk factors for bulimia nervosa and other psychiatric disorders.

BACKGROUND: The examination of opposite-sex and same-sex dizygotic twins allows us to explore the sex-specific comorbidity of psychiatric disorders. To date, this question has not been explored in eating disorders. OBJECTIVE: To determine whether sex influences shared risk factors between bulimia nervosa (BN) and other forms of psychopathology. DESIGN: The study examines associations between BN and other forms of psychopathology in twin pairs using interview and survey reports. SETTING: Twins from the Virginia population-based twin registry. PARTICIPANTS: Male-female dizygotic twins (N = 1192 pairs), mean (SD) age 36.6 (8.9) years, and female-female dizygotic twins (N = 467 pairs), mean (SD) age 36.0 (7.6) years. MAIN OUTCOME MEASURES: Lifetime psychiatric disorders as diagnosed by a structured psychiatric interview, including major depression, anxiety disorders, and substance abuse and dependence. Also, continuous measures of body mass index and personality, including neuroticism and novelty seeking. RESULTS: Significant within-person associations existed for women between BN and higher body mass index, neuroticism, novelty seeking, and all lifetime psychopathology. Results from this study suggest the presence of either familial or nonfamilial shared risk factors between BN and generalized anxiety disorder, neuroticism, psychoactive substance use, novelty seeking, major depression, and panic disorder. The shared risk factors between BN and generalized anxiety disorder and BN and novelty seeking were only present in men. CONCLUSION: Evidence supports the existence of a sex-specific manifestation of familial liability with respect to BN and generalized anxiety disorder and BN and novelty seeking.

Adult↗

PubMed2004

Differences between women with anorexia nervosa and restrained eaters on shape and weight concerns, self-esteem, and depression.

OBJECTIVE: The current study examined the relation among shape and weight concerns, domain-specific self-esteem, dietary restraint, and depression. METHOD: Women with anorexia nervosa (AN; n = 19), restrained eaters (n = 20), and unrestrained eaters (n = 21) completed measures of shape and weight concerns, depression, and self-esteem. RESULTS: Women with AN had significantly higher shape and weight concerns and lower self-esteem than restrained eaters. However, once depression was controlled, these significant differences disappeared on all but the morality self-esteem subscale. Unrestrained eaters had significantly lower shape and weight concerns and higher self-esteem than restrained participants both before and after depression was controlled. DISCUSSION: Shape and weight concerns and low self-esteem are associated with dietary restriction. However, results from the current study suggest these two variables may not be the primary driving forces behind extreme dietary restriction.

Adult↗

PubMed2004

A case series evaluation of guided self-help for bulimia nervosa using a cognitive manual.

OBJECTIVE: The current study examined the usefulness of a new, cognitive-based self-help manual for bulimia nervosa. METHOD: Twenty people were provided with assessment and six sessions of guided self-help using the manual. Participants were assessed for eating-related behaviors and attitudes and psychopathology at pretreatment, posttreatment, and at the 3-month follow-up. Assessment instruments included the Eating Disorder Examination, Symptom Checklist-90-Revised, Rosenberg Self-Esteem Scale, Screening Test for Co-morbid Personality Disorders, and The University of Rhode Island Change Assessment. Data from 15 people were available at posttreatment and from 13 people at follow-up. RESULTS: Using intention-to-treat analyses, binge eating, vomiting, four of the five eating attitudes and self-esteem significantly improved between pretreatment and posttreatment. At follow-up, there was continued improvement on all measures, with the exception of binge eating. DISCUSSION: Guided self-help using cognitive techniques is a promising first-line treatment for bulimia nervosa, with further evaluation required in a randomized, controlled trial with long-term follow-up.

Adult↗