"Se extraña todo:" Family separation and reunification experiences among unaccompanied adolescent migrants from Central America.

There has been a record surge of unaccompanied immigrant minors (UAMs) entering the United States, with 86% of those apprehended at the US-Mexico border originating from the Central American countries of El Salvador, Guatemala, and Honduras. A majority of immigrant children are separated from either one or both parents at various points during the migration process. Although average separations last 4 or more years, and may be deeply distressing, there is little research on family separations among Central American UAMs. Further, little is known about the developmental impact of separations from extended family networks, or about reunification. To address these empirical gaps, this study used community-participatory qualitative methods to deeply explore the lived experiences and emotional repercussions of family separation and reunification. The sample included 42 adolescents who had all recently migrated to the Western United States from Central America. Thematic analyses revealed that separation experiences are distressing, multifaceted, and have important developmental implications for Central American UAMs. Results illustrate the socioemotional toll that family separation and reunification can have on this vulnerable population, and highlight the need for culturally responsive, developmentally informed, and contextually appropriate care focused on family reunification in order to foster healthy psychosocial adjustment among UAMs.

Dietary Restriction Behaviors and Binge Eating in Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder: Trans-diagnostic Examination of the Restraint Model.

OBJECTIVE: To compare dietary restriction behaviors among adults with eating disorders involving binge eating, including anorexia nervosa-binge/purge subtype (AN-BE/P), bulimia nervosa (BN), and binge eating disorder (BED), and to examine whether dietary restriction behaviors impact binge eating frequency across diagnoses. METHOD: Participants included 845 treatment seeking adults (M=30.42+10.76years) who met criteria for DSM-5 AN-BE/P (7.3%;n=62), BN (59.7%;n=504), and BED (33.0%;n=279). All participants self-reported their past and current eating disorder symptoms on the Eating Disorder Questionnaire. RESULTS: Adults with AN-BE/P and BN reported significantly more dietary restriction behaviors (e.g. eating fewer meals per day, higher frequency of fasting, consuming small and low calorie meals) in comparison to adults with BED. Adults with AN-BE/P and BN who reported restricting food intake via eating fewer meals per day had more frequent binge eating episodes. However, adults with BN who reported restricting food intake via eating small meals and low calorie meals had less frequent binge eating episodes. DISCUSSION: This study provides mixed support for the restraint model by suggesting that not all dietary restriction behaviors are associated with higher levels of binge eating. It may be that adults with BN who report a higher frequency of eating small and low calorie meals display more control over their eating in general, and therefore also have lower frequency of binge eating. Clinicians should assess for dietary restriction behaviors at the start of treatment prior to assuming that all forms of strict dieting and weight control behaviors similarly impact binge eating.

Eating patterns in youth with restricting and binge eating/purging type anorexia nervosa.

OBJECTIVE: To describe eating patterns in youth with restricting and binge/purge type anorexia nervosa (AN) and to examine whether eating patterns are associated with binge eating or purging behaviors. METHOD: Participants included 160 children and adolescents (M = 15.14 ± 2.17 years) evaluated at The University of Chicago Eating Disorders Program who met criteria for DSM-5 restrictive type AN (AN-R; 75%; n = 120) or binge eating/purging type AN (AN-BE/P; 25%; n = 40). All participants completed the eating disorder examination on initial evaluation. RESULTS: Youth with AN-R and AN-BE/P differed in their eating patterns, such that youth with AN-R consumed meals and snacks more regularly relative to youth with AN-BE/P. Among youth with AN-BE/P, skipping dinner was associated with a greater number of binge eating episodes (r = -.379, p < .05), while skipping breakfast was associated with a greater number of purging episodes (r = -.309, p < .05). DISCUSSION: Youth with AN-R generally follow a regular meal schedule, but are likely consuming insufficient amounts of food across meals and snacks. In contrast, youth with AN-BE/P tend to have more irregular eating patterns, which may play a role in binge eating and purging behaviors. Adults monitoring of meals may be beneficial for youth with AN, and particularly those with AN-BE/P who engage in irregular eating patterns.

Family meal frequency among children and adolescents with eating disorders.

PURPOSE: Previous studies on family meals and disordered eating have mainly drawn their samples from the general population. The goal of the current study is to determine family meal frequency among children and adolescents with anorexia nervosa (AN), bulimia nervosa (BN), and feeding or eating disorder not elsewhere classified (FED-NEC) and to examine whether family meal frequency is associated with eating disorder psychopathology. METHODS: Participants included 154 children and adolescents (M = 14.92 ± 2.62), who met criteria for AN (n = 60), BN (n = 32), or FED-NEC (n = 62). All participants completed the Eating Disorder Examination and the Family Meal Questionnaire prior to treatment at the University of Chicago Eating Disorders Program. RESULTS: AN and BN participants significantly differed in terms of family meal frequency. A majority of participants with AN (71.7%), compared with less than half (43.7%) of participants with BN, reported eating dinner with their family frequently (five or more times per week). Family meal frequency during dinner was significantly and negatively correlated with dietary restraints and eating concerns among participants with BN (r = -.381, r = -.366, p < .05) and FED-NEC (r = -.340, r = -.276, p < .05). CONCLUSIONS: AN patients' higher family meal frequency may be explained by their parents' relatively greater vigilance over eating, whereas families of BN patients may be less aware of eating disorder behaviors and hence less insistent upon family meals. Additionally, children and adolescents with AN may be more inhibited and withdrawn and therefore are perhaps more likely to stay at home and eat together with their families.