The effect of academic stress and attachment stress on stress-eaters and stress-undereaters.

It is well established that stress is related to changes in eating patterns. Some individuals are more likely to increase their overall food intake under conditions of stress, whereas others are more likely to consume less food when stressed. Attachment style has been linked to disordered eating and eating disorders; however, comparisons of eating behaviors under attachment versus other types of stress have yet to be explored. The present laboratory study examined the eating patterns in self-identified stress-undereaters and stress-eaters under various types of stress. More specifically, the study examined the effects of academic and attachment stress on calorie, carbohydrate and sugar consumption within these two groups. Under the guise of critiquing student films, university students viewed either one of two stress-inducing videos (academic stress or attachment stress, both designed to be emotionally arousing) or a control video (designed to be emotionally neutral), and their food intake was recorded. Results demonstrated that the video manipulations were effective in inducing stress. Differential patterns of eating were noted based on group and stress condition. Specifically, stress-undereaters ate fewer calories, carbohydrates and sugars than stress-eaters in the academic stress condition, but not in the attachment stress or control condition. Findings suggest that specific types of stressors may influence eating behaviors differently.

Emotion-focused family therapy for eating disorders in children and adolescents.

UNLABELLED: Family-based therapy (FBT) is regarded as best practice for the treatment of eating disorders in children and adolescents. In FBT, parents play a vital role in bringing their child or adolescent to health; however, a significant minority of families do not respond to this treatment. This paper introduces a new model whereby FBT is enhanced by integrating emotion-focused therapy (EFT) principles and techniques with the aims of helping parents to support their child's refeeding and interruption of symptoms. Parents are also supported to become their child's 'emotion coach'; and to process any emotional 'blocks' that may interfere with their ability to take charge of recovery. A parent testimonial is presented to illustrate the integration of the theory and techniques of EFT in the FBT model. EFFT (Emotion-Focused Family Therapy) is a promising model of therapy for those families who require a more intense treatment to bring about recovery of an eating disorder. KEY PRACTITIONER MESSAGE: More intense therapeutic models exist for treatment-resistant eating disorders in children and adolescents. Emotion is a powerful healing tool in families struggling with an eating disorder. Working with parent's emotions and emotional reactions to their child's struggles has the potential to improve child outcomes.

Is the next generation of physicians adequately prepared to diagnose and treat eating disorders in children and adolescents?

This study examined medical residents' comfort with and knowledge of eating disorder assessment and treatment practices for children and adolescents. Since entering medical school, the majority of respondents reported receiving fewer than 5 hours of training in this area. Participants reported feeling more comfortable with the assessment of eating disorders than with their medical management and treatment. Questions testing participants' knowledge in these domains reflected this finding; participants did well on the assessment questions, but quite poorly on the treatment questions. Intensity of training and self-reported comfort with these skills predicted residents' knowledge, suggesting that additional training opportunities are warranted.

'I know I can help you': parental self-efficacy predicts adolescent outcomes in family-based therapy for eating disorders.

Family-based therapy is regarded as best practice for the treatment of eating disorders in adolescents. In family-based therapy, parents play a vital role in bringing their child or adolescent to health; however, little is known about the parent-related mechanisms of change throughout treatment. The present study examines parent and adolescent outcomes of family-based therapy as well as the role of parental self-efficacy in relation to adolescent eating disorder, depressed mood and anxiety symptoms. Forty-nine adolescents and their parents completed a series of measures at assessment, at 3-month post-assessment and at 6-month follow-up. Results indicate that, throughout treatment, parents experienced an increase in self-efficacy and adolescents experienced a reduction in symptoms. Maternal and paternal self-efficacy scores also predicted adolescent outcomes throughout treatment. These results are consistent with the philosophy of the family-based therapy model and add to the literature on possible mechanisms of change in the context of family-based therapy.

Assessment and treatment of pediatric eating disorders: a survey of physicians and psychologists.

OBJECTIVE: Studies show that primary care clinicians struggle with the assessment and treatment of eating disorders in adults. There are no known studies examining current practices of clinicians with respect to eating disorders in children and adolescents. The following study describes the key practices of primary care clinicians in Ontario, Canada, around the screening, assessment, and treatment of eating disorders in children and adolescents. METHOD: A 24-item survey was developed to obtain information from family physicians and psychologists about presenting complaints and current practices related to the assessment and treatment of eating disorders. RESULTS: Findings of this study suggest that despite discipline-specific differences, a large proportion of clinicians do not routinely screen for eating disorders, and when eating disorders are assessed and treatment is initiated, family members are not routinely involved in the process. CONCLUSION: In Ontario, primary care clinicians may benefit from more training and support to better identify and treat children and adolescents with eating disorders. In particular, clinicians may require additional training around screening, multi-informant assessment methods, as well as appropriate therapy techniques.