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An eating disorder is a mental disorder defined by abnormal eating behaviors that adversely affect a person's physical or mental health. These behaviors include eating either too much or too little. Types of eating disorders include binge eating disorder, where the patient keeps eating large amounts in a short period of time typically while not being hungry; anorexia nervosa, where the person has an intense fear of gaining weight and restricts food or overexercises to manage this fear; bulimia nervosa, where individuals eat a large quantity (binging) then try to rid themselves of the food (purging); pica, where the patient eats non-food items; rumination syndrome, where the patient regurgitates undigested or minimally digested food; avoidant/restrictive food intake disorder (ARFID), where people have a reduced or selective food intake due to some psychological reasons; and a group of other specified feeding or eating disorders. Anxiety disorders, depression and substance abuse are common among people with eating disorders. These disorders do not include obesity. People often experience comorbidity between an eating disorder and OCD. It is estimated 20–60% of patients with an ED have a history of OCD.
Bulimia nervosa, also known simply as bulimia, is an eating disorder characterized by binge eating, followed by purging or fasting, as well as excessive concern with body shape and weight. This activity aims to expel the body of calories eaten from the binging phase of the process. Binge eating refers to eating a large amount of food in a short amount of time. Purging refers to the attempts to get rid of the food consumed. This may be done by vomiting or taking laxatives.
Psychological testing refers to the administration of psychological tests. Psychological tests are administered or scored by trained evaluators. A person's responses are evaluated according to carefully prescribed guidelines. Scores are thought to reflect individual or group differences in the construct the test purports to measure. The science behind psychological testing is psychometrics.
Perfectionism, in psychology, is a broad personality trait characterized by a person's concern with striving for flawlessness and perfection and is accompanied by critical self-evaluations and concerns regarding others' evaluations. It is best conceptualized as a multidimensional and multilayered personality characteristic, and initially some psychologists thought that there were many positive and negative aspects.
The Liebowitz Social Anxiety Scale (LSAS) is a short questionnaire developed in 1987 by Michael Liebowitz, a psychiatrist and researcher at Columbia University and the New York State Psychiatric Institute. Its purpose is to assess the range of social interaction and performance situations feared by a patient in order to assist in the diagnosis of social anxiety disorder. It is commonly used to study outcomes in clinical trials and, more recently, to evaluate the effectiveness of cognitive-behavioral treatments. The scale features 24 items, which are divided into two subscales. 13 questions relate to performance anxiety and 11 concern social situations. The LSAS was originally conceptualized as a clinician-administered rating scale, but has since been validated as a self-report scale.
The Eating Attitudes Test, created by David Garner, is a widely used 26-item, standardized self-reported questionnaire of symptoms and concerns characteristic of eating disorders. The EAT is useful in assessing "eating disorder risk" in high school, college and other special risk samples such as athletes. EAT has been extremely effective in screening for anorexia nervosa in many populations.
The Eating Disorder Inventory (EDI) is a self-report questionnaire used to assess the presence of eating disorders, (a) anorexia nervosa both restricting and binge-eating/purging type; (b) bulimia nervosa; and (c) eating disorder not otherwise specified including binge eating disorder. The original questionnaire consisted of 64 questions, divided into eight subscales. It was created in 1984 by David M. Garner and others. There have been two subsequent revisions by Garner: the Eating Disorder Inventory-2 (EDI-2) and the Eating Disorder Inventory-3 (EDI-3).
The SCOFF questionnaire utilizes an acronym in a simple five question test devised for use by non-professionals to assess the possible presence of an eating disorder. It was devised by Morgan et al. in 1999. The original SCOFF questionnaire was devised for use in the United Kingdom, thus the original acronym needs to be adjusted for users in the United States and Canada. The "S" in SCOFF stands for "Sick" which in British English means specifically to vomit. In American English and Canadian English it is synonymous with "ill". The "O" is used in the acronym to denote "one stone". A "stone" is an Imperial unit of weight which made up of 14 lbs. The letters in the full acronym are taken from key words in the questions:
The Minnesota Eating Behavior Survey (MEBS) is a 30 item self-report questionnaire used to assess the presence of an eating disorder. It is designed for use with both male and females age 10 to adult. The MEBS was originally designed for use by McGue et al. in the Minnesota Twin Family Study (MTFS) a longitudinal study to assess the onset of psychological pathology including eating disorders among 1,400 twin girls and their parents.
The Health Dynamics Inventory (HDI) is a 50 item self-report questionnaire developed to evaluate mental health functioning and change over time and treatment. The HDI was written to evaluate the three aspects of mental disorders as described in the Diagnostic and Statistical Manual of Mental Disorders (DSM): "clinically significant behavioral or psychological syndrome or pattern...associated with present distress...or disability". This also corresponds to the phase model described by Howard and colleagues Accordingly, the HDI assesses (1) the experience of emotional or behavioral symptoms that define mental illness, such as dysphoria, worry, angry outbursts, low self-esteem, or excessive drinking, (2) the level of emotional distress related to these symptoms, and (3) the impairment or problems fulfilling the major roles of one's life.
Cognitive behavioral therapy (CBT) is derived from both the cognitive and behavioral schools of psychology and focuses on the alteration of thoughts and actions with the goal of treating various disorders. The cognitive behavioral treatment of eating disorders emphasizes on the minimization of negative thoughts about body image and the act of eating, and attempts to alter negative and harmful behaviors that are involved in and perpetuate eating disorders. It also encourages the ability to tolerate negative thoughts and feelings as well as the ability to think about food and body perception in a multi-dimensional way. The emphasis is not only placed on altering cognition, but also on tangible practices like making goals and being rewarded for meeting those goals. CBT is a "time-limited and focused approach" which means that it is important for the patients of this type of therapy to have particular issues that they want to address when they begin treatment. CBT has also proven to be one of the most effective treatments for eating disorders.
The Behavior Rating Inventory of Executive Function (BRIEF) is an assessment of executive function behaviors at home and at school for children and adolescents ages 5–18. It was originally developed by Gerard Gioia, Peter Isquith, Steven Guy, and Lauren Kenworthy
Other specified feeding or eating disorder (OSFED) is a subclinical DSM-5 category that, along with unspecified feeding or eating disorder (UFED), replaces the category formerly called eating disorder not otherwise specified (EDNOS) in the DSM-IV-TR. It captures feeding disorders and eating disorders of clinical severity that do not meet diagnostic criteria for anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), avoidant/restrictive food intake disorder (ARFID), pica, or rumination disorder. OSFED includes five examples:
The Child Mania Rating Scales (CMRS) is a 21-item diagnostic screening measure designed to identify symptoms of mania in children and adolescents aged 9–17 using diagnostic criteria from the DSM-IV, developed by Pavuluri and colleagues. There is also a 10-item short form. The measure assesses the child's mood and behavior symptoms, asking parents or teachers to rate how often the symptoms have caused a problem for the youth in the past month. Clinical studies have found the CMRS to be reliable and valid when completed by parents in the assessment of children's bipolar symptoms. The CMRS also can differentiate cases of pediatric bipolar disorder from those with ADHD or no disorder, as well as delineating bipolar subtypes. A meta-analysis comparing the different rating scales available found that the CMRS was one of the best performing scales in terms of telling cases with bipolar disorder apart from other clinical diagnoses. The CMRS has also been found to provide a reliable and valid assessment of symptoms longitudinally over the course of treatment. The combination of showing good reliability and validity across multiple samples and clinical settings, along with being free and brief to score, make the CMRS a promising tool, especially since most other checklists available for youths do not assess manic symptoms.
Christopher James Alfred Granville Fairburn is a British psychiatrist and researcher. He is Emeritus Professor of Psychiatry at the University of Oxford. He is known for his research on the development, evaluation and dissemination of psychological treatments, especially for eating disorders.
The Attribution Questionnaire (AQ) is a 27-item self-report assessment tool designed to measure public stigma towards people with mental illnesses. It assesses emotional reaction and discriminatory responses based on answers to a hypothetical vignette about a man with schizophrenia named Harry. There are several different versions of the vignette that test multiple forms of attribution. Responses assessing stigma towards Harry are in the form of 27 items rated on a Likert scale ranging from 1 (not at all) to 9 (very much). There are 9 subscales within the AQ that breakdown the responses one could have towards a person with mental illness into different categories. The AQ was created in 2003 by Dr. Patrick Corrigan and colleagues and has since been revised into smaller tests because of the complexity and hypothetical that did not capture children and adolescent's stigmas well. The later scales are the Attribution Questionnaire-9 (AQ-9), the revised Attribution Questionnaire (r-AQ), and the children's Attribution Questionnaire (AQ-8-C).
The Tourette's Disorder Scale (TODS) is a psychological instrument to assess tics and co-occurring conditions in Tourette syndrome (TS).
Body image disturbance (BID) is a common symptom in patients with eating disorders and is characterized by an altered perception of one's own body.
A variety of behaviors whereby people are highly selective in what they eat and do not eat are known as picky eating or selective eating. Selective eating is common in younger children and can also sometimes be seen in adults.
References
- ↑ Cooper, Z; Fairburn, CG (1987). "The Eating Disorder Examination: A semistructured interview for the assessment of the specific psychopathology of eating disorders". International Journal of Eating Disorders. 6: 1–8. doi:10.1002/1098-108x(198701)6:1<1::aid-eat2260060102>3.0.co;2-9.
- ↑ Fairburn, CG; Cooper, Z; Doll, HA; Davies, BA (2005). "Identifying Dieters Who Will Develop an Eating Disorder: A Prospective, Population-Based Study". The American Journal of Psychiatry. 162 (12): 2249–55. doi:10.1176/appi.ajp.162.12.2249. PMC 3035832 . PMID 16330587.
- ↑ International Journal of Eating Disorders Volume 25 Issue 3
- ↑ Bryant-Waugh, Rachel J.; Cooper, Peter J.; Taylor, Catherine L.; Lask, Bryan D. (May 1996). "The use of the eating disorder examination with children: A pilot study". International Journal of Eating Disorders. 19 (4): 391–397. doi:10.1002/(SICI)1098-108X(199605)19:4<391::AID-EAT6>3.0.CO;2-G. ISSN 0276-3478. PMID 8859397.
- ↑ Couturier, Jennifer; Lock, James; Forsberg, Sarah; Vanderheyden, Debbie; Yen, Huei Lee (July 2007). "The addition of a parent and clinician component to the eating disorder examination for children and adolescents". International Journal of Eating Disorders. 40 (5): 472–475. doi:10.1002/eat.20379. PMID 17726771.
Fairburn C, Cooper Z. The eating disorder examination. In: Fairburn C, Wilson G, editors. Binge eating: Nature, assessment, and treatment. 12. New York: Guilford Press; 1993