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Biomedical subjects

W Vandereycken

Publications and source records attributed to W Vandereycken.

At least 19 recordsLinked to original sources
PubMed2006

Psychomotor performance and sequence planning in anorexia nervosa before and after weight restoration.

BACKGROUND: In the study of psychomotor performance in anorexia nervosa (AN), motor control has not been studied extensively. The present study explores sequence planning in a sample of AN patients. METHOD: A group of 26 female restricting AN inpatients, aged 14 to 25, was compared with 24 healthy women matched for age and educational level. During the performance of a simple copying task, in which movement planning, but not working capacity, was challenged, the ease with which generally favored graphic production rules could be applied was manipulated. Computerized recordings of the drawing movements allowed detailed analyses of reaction and movement times and of drawing sequences. Fifteen patients were retested after weight restoration, as were 15 controls. RESULTS: Copying patterns that normally elicit a conflict between preferred graphic production rules induced significantly less slowing in the reaction times of the anorexia nervosa patients than in the controls, both before and after weight restoration. There were no group differences as regards the consistency with which the implicit production rules were applied. DISCUSSION: AN patients seem to show a fast response style combined with good sequence planning capacity.

Adaptation, Psychological↗
PubMed2006

[Bitter and gilded pills: psychiatry in the light (or shadow) of the pharmaceutical industry].

Psychotropic medication has brought about far-reaching changes in psychiatry: in its nature and practice, its image of man and its public image. Never before have so many psychotropic drugs been prescribed for young people. 'Difficult' children are now referred to as ADHD children and moody youngsters are given antidepressants. In adult psychiatry treatment is being dictated more and more by protocols and guidelines: very often medication is the treatment of choice. The reasons for this are largely economic. Increasingly 'research' is being sponsored by the pharmaceutical industry. Published research results are often skewed so as to favour the sponsor. Some scientific journals owe their survival to drug advertisements. Even some patient organisations are supported by the pharmaceutical industry. How will psychiatry and mental health care be able to escape from this 'straightjacket' in the future? The purpose of this polemical essay is to draw the attention of health care professionals and researchers to this rather worrying development.

Advertising↗
PubMed2004

The predictive value of body mass index for the weight evolution in anorexia nervosa.

BACKGROUND: Low body weight is considered to be an important risk factor for poor outcome in anorexia nervosa (AN). OBJECTIVES: To study the relationship between body mass index (BMI) at the beginning of treatment and at follow-up. A BMI of 13 kg/m2 at admission was hypothesized as cut-off point for better versus worse evolution of weight after treatment. METHOD: The BMI of 232 female AN inpatients was calculated at admission and after 6 months and 1 year. RESULTS: An overall low correlation between BMI at admission and at 6 months (r = 0.27) and 1 year (r = 0.26) follow-up was found. A BMI value of 15 kg/m2 at admission was revealed as the best cut-off point for making predictions. CONCLUSIONS: Patients with an admission BMI below 15 kg/m2 have a significantly greater chance to develop a lower BMI value at follow-up than those with a higher BMI.

Adult↗
PubMed2004

Which factors do provoke binge eating? An exploratory study in eating disorder patients.

OBJECTIVE: To study the different factors (external, emotional, cognitive, and physiological) which may trigger binge eating in eating disorder patients and to make a comparison of binge eating triggers in different eating disorder samples, i.e. anorexia nervosa bingeing-purging type and bulimia nervosa (BN). METHOD: A total of 242 eating disorder patients filled out the Binge Eating Trigger Checklist (BETCH), a new screening device to evaluate the type of situations (and their experienced discomfort) which subjects identify as antecedents of a binge eating episode. RESULTS: Eating disorder patients report a combination of negative emotions, physiological states (urge for sweets) and negative cognitions as most important antecedents for their bingeing episodes. External stimuli were only reported by a small number of patients and provoked significantly lower levels of discomfort. A comparison of binge eating triggers in bingeing anorexia nervosa patients and bulimic patients showed only a few significant differences. CONCLUSIONS: Binge eating, as perceived and reported by eating disorder patients, seems to be provoked by a combination of different antecedents, both emotional, cognitive and physiological. Remarkably enough, binge eating triggers did not differ between bingeing anorectic patients and patients suffering from BN.

Adult↗
PubMed2001

Which factors do provoke binge-eating? An exploratory study in female students.

To study the different factors (external, emotional, cognitive, and physiological) which may trigger binge-eating in young females. A total of 110 female students (between 14 and 25 years of age) filled out the Eating Disorder Inventory (EDI) and the Binge Eating Trigger Checklist (BETCH), a new screening device to evaluate the type of situations (and their experienced discomfort) which subjects identify as antecedents of a binge-eating episode. Approximately 41% of the female students reported binge-eating and 15% admitted they have daily binges. The binge-eating triggers most frequently reported and at the same time having the highest level of discomfort were emotional triggers (feeling bored, depressed, anxious, tense, and sad) and physiological triggers (being hungry and feeling an urge to eat sweets). Fewer food-related cues have been reported whereas dysfunctional cognitions were rarely mentioned as antecedents of binge-eating. Binge-eating, as perceived and reported by female students, seems to be provoked by a combination of different antecedents, both emotional and physiological.

Journal Article↗
PubMed2001

Self-injurious behaviors in eating-disordered patients.

High rates of self-injurious behaviors (SIBs) have been described in eating-disordered patients. The present study in 134 female inpatients suffering from an eating disorder (ED) confirmed this: 44% of the total group reported at least one form of SIB (mostly hair pulling, scratching, cutting, or bruising) with a mean age at onset of 17.5 years. No major differences have been found between the subgroups (anorexics, bulimics). The considerable number of patients who did not feel any pain during SIB showed more tendency towards dissociative experiences. Those who admitted SIB reported higher levels of psychological dysfunctioning, dissociative experiences, and impulsiveness.

Journal Article↗
PubMed2001

Body composition of anorexia nervosa patients assessed by underwater weighing and skinfold-thickness measurements before and after weight gain.

BACKGROUND: Weight restoration is a crucial element in the treatment of patients with anorexia nervosa. Therefore, the validity of different methods for measuring body composition is important. OBJECTIVE: We tested the concurrent validity of hydrodensitometry (underwater weighing) and anthropometry (12 skinfold thicknesses) and assessed body composition and subcutaneous fat before and after a refeeding program and a multifaceted program of therapy in a specialized inpatient unit for eating disorders. DESIGN: The body composition of a large sample of anorexia nervosa patients (97 restricting type, 33 binging-purging type) was studied by using 2 methods both before and after weight gain. We applied a behavioral contract for weight restoration with a minimum weekly gain of 700 g and a maximum of 3 kg. Bland-Altman analysis of agreement, Pearson correlation analysis, t tests, and analysis of covariance were used. RESULTS: There was good agreement between the results obtained by underwater weighing and by skinfold-thickness measurement (r = 0.76, P < 0.001); the results produced by the 2 methods did not differ significantly. On average, a significant weight gain (11.9 kg) was observed, composed of 6.6 kg fat and 5.3 kg fat-free mass. CONCLUSIONS: Body fat estimation by skinfold-thickness equation appeared to be as accurate as underwater weighing. The refeeding program led to a significant increase in body weight, of which 55.5% was body fat. The mean ratio of fat-free mass to fat mass at the end of the treatment was 3.4:1.

Adipose Tissue↗
PubMed2001

The management of eating disorders in a fertility clinic: clinical guidelines.

Although the wish for a child may be ambivalent in women with anorexia or bulimia nervosa, the prevalence of eating disorders in fertility clinics is probably underestimated. Motivated by the wish for a child, these couples may be reluctant to reveal a history of an eating disorder and/or show resistance to some therapy for this disorder. Nevertheless, in our opinion, the eating disorder must be in full remission before any fertility treatment can start, if treatment is still necessary at that moment. Illustrated with some case examples, we will discuss the major problems and clinical strategies in the management of these complex cases, based upon the experience in our own fertility clinic.

Counseling↗
PubMed2000

Food refusal and insanity: sitophobia and anorexia nervosa in Victorian asylums.

Although anorexia nervosa emerged as a new syndrome in the second half of the 19th century, this clinical picture seemed to be unknown in the psychiatric hospitals or asylums. In asylum medicine, the commonly used concept of sitophobia to designate food refusal in the insane covered a wide variety of mental disturbances and cannot be plainly equated with anorexia nervosa. A major difference is the occurrence of hallucinations and delusions specifically centered around religion and digestion. Most probably, anorectic patients were not treated in asylums, but at home, in the doctor's office, or in general hospitals. This pattern may be partly attributed to the fact that both patients and doctors were focusing on symptoms of self-starvation like emaciation, constipation, and amenorrhea, which were primarily interpreted as referring to somatic diseases. Additionally, wealthy families probably preferred private care in water-cure establishments, sanatoria, and rest homes to the stigmatizing referral of their anorectic daughter to an asylum. Hence, the fact that late 19th-century institutionalized psychiatry was only incidentally confronted with anorexia nervosa may explain its lack of interest in the emerging syndrome.

Feeding Behavior↗
PubMed1999

Body experience in eating disorders before and after treatment: a follow-up study.

Since body dissatisfaction is an essential part of anorexia/bulimia nervosa, we wanted to assess the patients' body experience before and after intensive treatment. Body experience was studied in 290 eating disorder patients, admitted to a specialised unit, after six months and again after one year using the Body Attitude Test (BAT), the Eating Disorder Inventory (EDI), and the Eating Disorder Evaluation Scale (EDES). The clearly negative body experience of eating disorder patients evolved in a positive way after therapy and this improvement lasted for up to one year after admission. EDI scores and Body Mass Index at the time of admission appeared to be the strongest predictors of the total BAT score at follow-up. Although body dissatisfaction can be quite persistent in eating disorders, intensive treatment can substantially improve the patients' body experience.

Adult↗
PubMed1998

The significance of body size estimation in eating disorders: its relationship with clinical and psychological variables.

OBJECTIVE: To assess the relationship between body size estimation on the one hand and clinical and psychological variables on the other. METHOD: Body size estimation was tested with the video distortion method on a life-size screen in normal women (n = 45) and compared to a total of 189 female eating disorder patients (100 with restricting anorexia nervosa, 41 with binging/purging anorexia nervosa, 48 with bulimia nervosa). The subjects' cognitive responses (what they think they really look like), affective responses (what they feel they look like), and optative responses (what they want to look like) were correlated with clinical parameters (including body composition) and with the scores on a series of self-report questionnaires assessing general psychological well-being and body experience. RESULTS: No significant relationship was found between the body size estimations and the clinical variables. The cognitive and affective responses showed a moderate relationship with self-reported body attitude. Body dissatisfaction was negatively correlated with the optative response (desired body size). DISCUSSION: This study contributes to the construct validity of the video distortion method. Body size estimation includes more than just a perceptual task. Hence, the narrow notion of body image should be replaced by the more complex construct of "body experience," the multidimensionality of which should be addressed in both research and treatment of eating-disordered patients.

Adolescent↗
PubMed1997

Further experience with the Body Attitude Test.

The Body Attitude Test (BAT) questionnaire was specifically developed for the assessment of patients with eating disorders. To test its usefulness, the BAT was administered together with other self-report measures (Body Shape Questionnaire, Eating Disorder Inventory, Body Attitude Questionnaire, Rosenberg Self-Esteem Scale) in 69 anorectic, 26 bulimic patients and 165 female university students. The results indicate that the negative body attitude expressed on the BAT is related to other signs of negative body experience. The BAT differentiates between clinical and non-clinical subjects and between anorectics and bulimics.

Adult↗
PubMed1997

Psychological aspects of childhood obesity: a controlled study in a clinical and nonclinical sample.

Explored the relationship between obesity and psychosocial adjustment in a combined clinical and nonclinical sample of 139 obese children and 150 non-obese children (ages from 9 to 12 years and matched for age, socioeconomic status, and gender) who filled out the Perceived Competence Scale for Children; their parents completed the Child Behavior Checklist. All obese children, independent of their help-seeking status, reported more negative physical self-perceptions than their nonobese peers and they scored lower on general self-worth. According to their parents, the obese children of the clinical sample appeared to have more behavior problems. Findings suggest that psychopathology depends on a clinical obese status, and they provide evidence for a psychosocial at-risk profile for a subgroup of obese children.

Achievement↗
PubMed1997

Body-size estimation in eating disorders using video distortion on a life-size screen.

BACKGROUND: The video-distortion method on a life-size screen is one of the new methods to systematically study the body experience of eating-disordered patients. METHODS: Using this method, we have studied body-size estimation in female patients suffering from eating disorders: anorexia nervosa restricting type (n = 87) and mixed type (n = 34); bulimia nervosa (n = 44), and a normal control group (n = 45). Subjects had to estimate a neutral object (neutral response) and their own body size: what they think they really look like (cognitive response); what they feel they look like (affective response), and what they want to look like (optative response). RESULTS: No significant differences were found for the neutral and the cognitive response. Eating-disordered patients clearly did not overestimate their body size. The different subgroups showed interesting differences in the degree of discrepancy between cognitive and affective responses, and in the thinness of their body ideal. CONCLUSIONS: Researchers should focus on these elements of body experience, because they are clinically far more relevant than the simple question of over/underestimation.

Adult↗
PubMed1996

Body composition in female anorexia nervosa patients.

For the first time, body composition has been studied in a very large sample of female anorexia nervosa patients (n 200) using two methods: anthropometry (skinfold thickness) and densitometry (underwater weighing). The concurrent validity of both methods appeared to be good (r 0.84). Although the mean percentage of body fat (13.5) in our sample corresponds with most of the previous reports, the range (4.3-24.8) is great. Our study shows that BMI is not a good measure of fatness. Age and duration of illness were not related to body fat. Percentage fat was found to be different (t 2.76, P < 0.01) according to the diagnostic subtype of anorexia nervosa: restricters (12.9) v. bingers and/or purgers (14.7).

Adipose Tissue↗
PubMed1996

[The anorectic life of Empress Elisabeth of Austria (1837-1898). Slenderness cult of the Habsburg family].

Empress Elisabeth of Austria (1837-1898), known for her beauty as well as for her opposition to the ceremonial court of the Austrian ruling family, suffered from a disease that has been termed typical for modern-day industrial nations. The biography of the Empress discloses information revealing symptoms of anorexia nervosa. Over a period of decades she developed strategies for weight reduction such as fasting rituals, gymnastics, hour-long horse-riding and forced marching. Numerous documents repeatedly describe her considerable fear of weight gain and the psychopathological changes specific for anorexia nervosa. Up to her death she succeeded in restricting to a minimum not only her body weight but also her social obligations. The documents on the life of Empress Elisabeth suggest that cultural, historical and psychodynamic factors play an important role in the genesis of this disorder.

Anorexia Nervosa↗
PubMed1995

Marital communication in eating disorder patients: a controlled observational study.

In order to investigate the communication between 21 eating disorder (ED) patients and their husbands, an observational study was carried out using two matched control groups of 21 maritally distressed (MD) and 21 nondistressed (ND) couples. During some discussion tasks the interaction was videotaped and the (verbal and nonverbal) communication skills were rated afterwards according to the Kategoriensystem für Partnerschaftliche Interaktion (KPI) coding system. Unexpectedly, compared with the control groups ED couples do not show a greater disequilibrium (between patient and husband) in the emission rate of positive and negative messages. Also striking is the generally higher degree of self-disclosure in ED couples than in ND couples, but this may reflect their experience of distress. Overall and most importantly, ED couples appear to lack some of the ND couples' skills of constructive communication, but manage to avoid the destructive communication style of MD couples.

Adult↗