Parental bonding and eating disorders: a systematic review.

This article systematically reviewed studies of parental bonding in people with eating disorders. MEDLINE, PsychINFO, EMBASE and CINAHL were searched to identify studies that compared parental bonding in people diagnosed with an eating disorder relative to non-clinical controls. Twenty-four studies were identified. Women with eating disorders typically reported lower parental care and higher parental protection compared to non-clinical, but not psychiatric, controls. Interestingly, a modest number of studies found that these relationships were mediated by avoidant problem solving style and several schemas from the Young Schema Questionnaire (YSQ; Schmidt, Joiner, Young, & Telch, 1995). While there are methodological limitations associated with the reviewed studies, they do offer some support for the proposal that difficulties in parent-child relationships predispose women to eating disorders and other psychiatric diagnoses.

A systematic review of measures of therapeutic engagement in psychosocial and psychological treatment.

This article reports a systematic review of engagement measures for psychosocial therapy. MEDLINE, EMBASE, and PsycINFO databases were searched to identify English-language studies (published 1980 to February 2010) that reported on an instrument/rating scale to measure engagement in psychosocial treatment for mental health difficulties. Forty-seven studies were identified, reporting information on 40 measures of treatment engagement. Although our findings suggest that therapeutic engagement appears to be considered an important construct to assess, they also reveal that there is little consensus in the definition of engagement employed. Few measures are generalizable across treatment settings and clinical populations, and limited information is reported on the indices of reliability and validity. It is concluded that further work is required to develop adequate measures of therapeutic engagement.

The role of sensitivity to reward and impulsivity in food-cue reactivity.

Exposure to the visual and olfactory characteristics of food can elicit a desire to eat and can stimulate food intake. This study sought to determine the extent to which sensitivity to reward and impulsivity are associated with this 'food-cue reactivity' in two motivational states (food deprived and non-food deprived). Female participants (N=120) were exposed to a pizza cue for three minutes whilst food deprived and non-food deprived. Before and after this period, three measures of food-cue reactivity were taken (ratings of desire to eat, craving, and desired portion size of the cued food). Two important findings emerged from the study. Firstly, individuals with higher levels of trait impulsivity experienced greater changes in appetite ratings in both motivational states (food deprived and non-food deprived). They also reported greater changes in desired portion size of a cued food when food deprived. Secondly, individuals with a high sensitivity to reward experienced a greater change in their desired portion of the cued food, but only when non-food deprived. These results indicate that individual differences in food-cue reactivity could be related to variation in sensitivity to stimuli that predict the occurrence of a reward, and to an inability to exercise sufficient self control in the presence of tempting environmental stimuli.

Individual differences in food-cue reactivity. The role of BMI and everyday portion-size selections.

This study sought to explore the association between sensitivity to food cues (sight and smell of food) and (i) body weight (overweight or non-overweight), (ii) typical everyday portion sizes, and (iii) the DEBQ-restraint scale. One hundred and twenty female participants (aged between 18 and 30) were exposed to the sight and smell of pizza for three minutes. Both before and after this period, three measures of food-cue reactivity were taken (ratings of desire to eat, craving, and a measure of desired portion size of the cued food). Separate regression analyses were used to explore the associations between the change in measures of cue reactivity from pre- to post-cue exposure, and (i) an overweight/non-overweight classification, (ii) a measure of participants everyday portion-size selection, and (iii) scores on the DEBQ-restraint scale. This analysis revealed that scores on the DEBQ-restraint scale were not significantly associated with changes in food-cue reactivity. However, individuals identified as overweight, and participants who reported consuming the largest everyday portion sizes, experienced a significantly greater change in their desired portion size of the cued food. The findings suggest that heightened food-cue reactivity might present an under-explored risk factor for overeating, and becoming overweight, and/or maintaining an overweight body shape.