ABSTRACT
Objective: We describe cognitive-behavioral therapy for bulimia nervosa (CBT-BN) with a Latina woman that incorporates culturally relevant topics. Method: A single case report of a 31-year-old monolingual Latina woman with BN describes the application of a couple-based intervention adjunctive to CBT-BN. Results: The patient reported no binge and purge episodes by session 20 and remained symptom free until the end of treatment (session 26). Improvement was observed in the Eating Disorders Examination (EDE) comparing baseline (EDE=5.74) with post treatment (EDE=1.25). Conclusions: The case illustrates how cultural adaptations such as including a family member, being flexible on topics and scheduling, and providing culturally relevant interventions can lead to successful completion of a course of therapy and facilitate ongoing interventions to ensure continued recovery.
Objetivo: Describimos la terapia cognitiva conductual para la bulimia nerviosa (TCC-BN) con una mujer latina incorporando tópicos que son culturalmente relevantes. Método: Un estudio de caso de una mujer latina monolingüe de 31 años con BN en el que se describe la incorporación de una intervención de pareja adjunta al TCC-BN. Resultados: Para la sesión 20, la paciente no reportó atracones ni conductas purgativas y continuó libre de síntomas hasta el final del tratamiento (sesión 26). La mejoría se observó en el Eating Disorders Examination (EDE) al comparar la evaluación de base (EDE=5.74) con la evaluación post tratamiento (EDE=1.25). Conclusión: El caso ilustra como adaptaciones culturales como incluir a un miembro familiar, ser flexible en los tópicos y en la agenda de trabajo, y proveer intervenciones culturalmente relevantes pueden llevar a una exitosa culminación de un proceso terapéutico y facilita las intervenciones que se llevan a cabo para asegurar un continuo proceso de recuperación.
ABSTRACT
Los trastornos de la conducta alimentaria (TCA) ocurren en todos los grupos étnicos y niveles socioeconómicos. Sin embargo, los tratamientos basados en la evidencia para los TCA han sido desarrollados mayormente para la población caucásica. Con el propósito de desarrollar un modelo de intervención culturalmente sensible, los objetivos de este trabajo fueron: 1) identificar y describir algunos de los elementos culturales pertinentes al tratamiento de los TCA en la población latina y, 2) esbozar un modelo de intervención para los TCA que sea culturalmente sensible a la población latina de los Estados Unidos. El desarrollo de intervenciones culturalmente sensibles es un componente importante para reducir la disparidad en los servicios de salud brindados a la población latina residente en los Estados Unidos.
Eating disorders affect all ethnic and socioeconomic groups. However, currently available assessment instruments, which were developed and validated for exclusively Caucasian populations. With the purpose to develop a culturally sensitive framework for the eating disorders treatment in Latinos/as, the objectives of this work were: 1) identify and describe some of the relevant cultural elements for eating disorders in the Latino population and, 2) to draft a culturally sensitive intervention model for eating disorders in Latino population in the United States. Providing culturally sensitive treatments for Latinos with psychiatric disorders is essential to reverse public health disparities.
ABSTRACT
OBJECTIVE: To review the recent literature relevant to genetic research in eating disorders and to discuss unique issues which are crucial for the development of a genetic research project in eating disorders in Brazil. METHOD: A computer literature review was conducted in the Medline database between 1984 and may 2005 with the search terms "eating disorders", "anorexia nervosa", "bulimia nervosa", "binge eating disorder", "family", "twin" and "molecular genetic" studies. RESULTS: Current research findings suggest a substantial influence of genetic factors on the liability to anorexia nervosa and bulimia nervosa. Genetic research with admixed populations should take into consideration sample size, density of genotyping and population stratification. Through admixture mapping it is possible to study the genetic structure of admixed human populations to localize genes that underlie ethnic variation in diseases or traits of interest. CONCLUSIONS: The development of a major collaborative genetics initiative of eating disorders in Brazil and South America would represent a realistic possibility of studying the genetics of eating disorders in the context of inter ethnic groups, and also integrate a new perspective on the biological etiology of eating disorders.
OBJETIVO: Revisar a literatura atual concernente à pesquisa genética em transtornos do comportamento alimentar e discutir questões relevantes ao desenvolvimento de um projeto de pesquisa genética nessa área no Brasil. MÉTODO: A revisão realizada utilizou a base de dados Medline, no período de 1984 a maio de 2005, com os seguintes termos de busca: "anorexia nervosa", "bulimia nervosa", "eating disorders", "binge eating disorder", "family studies", "twin studies", "molecular genetics studies". RESULTADOS: Os dados atuais apontam para uma contribuição relevante dos fatores genéticos na suscetibilidade à anorexia e à bulimia nervosa. A pesquisa genética com populações miscigenadas deve levar em consideração o tamanho da amostra, a densidade de genotipagem e a estratificação populacional. Através de "admixture mapping" é possível estimar a estrutura genética destas populações e localizar genes relacionados à variação étnica de doenças ou traços de interesse. CONCLUSÕES: O desenvolvimento de uma grande iniciativa de colaboração em genética de transtornos alimentares no Brasil e na América Latina viabilizará estudar os fatores genéticos em transtornos do comportamento alimentar no contexto de grupos inter-étnicos, e integrar uma nova perspectiva biológica à etiologia destes distúrbios.