Onset Of Bulimia Nervosa Research Articles

6.3 EVIDENCE-BASED TREATMENT OF BULIMIA NERVOSA AND BINGE-EATING DISORDER

Despite the onset of bulimia nervosa and binge-eating disorder in adolescence, there are few treatments that have been specifically tested in this population. This presentation will review the evidence, describe the treatments with current research support, and discuss the potential use of evidence-based treatments used for adults as well as the considerations and adaptations that should be applied.

1.24 A Resting State Functional Magnetic Resonance Imaging (fMRI) Study of Attention Network Dysfunction in Adolescents With Bulimia Nervosa

The onset of bulimia nervosa (BN) in adolescence typically involves loss-of-control (LOC) eating followed by compensatory behaviors to avoid weight gain. Patients often exhibit a preoccupation with food- and weight-related stimuli, and these maladaptive cognitions are thought to impair information processing by influencing or disrupting attentional processes. In addition to these attentional problems, recent evidence suggests that childhood diagnosis of ADHD is associated with more severe BN symptoms in adolescents. Despite these clinical findings, little is known about the underlying neural mechanisms that govern attentional processes in BN.

Living with bulimia nervosa: a case report

Eating disorders are characterized by the deterioration of eating behavior in various ways due to biological, psychological, familial, and socio-cultural factors. The prevalence of eating disorders is reported around 1% for anorexia nervosa (AN), 2-4% for bulimia nervosa (BN), and 3-4% for binge eating disorder (BED) in Western societies. The increasing of frequency in eating disorders is thought to be associated with cultural changes, increasing assimilation of Western culture and industrialization, weakening of family relations, and diminishing of social support. This increase in prevalence appeals more academic interest to this topic. BN is a life-threatening disorder that is characterized by recurrent binge eating episodes followed by self-induced vomiting or other compensatory methods (e.g., abuse of laxatives, diuretics, or excessive exercise) to prevent weight gain. The disorder is more common in women and average age of onset of BN in women is reported to be earlier than men (15-18 years). In this case report, we discuss a 46-year-old woman with the recurrent binge eating episodes followed by self- induced vomiting for 27 years, in the framework of her background and medical history, and dynamic theories of psychiatry.

Adolescent Bulimia Nervosa

Onset of bulimia nervosa (BN) typically occurs in adolescence and is frequently accompanied by medical and psychiatric sequelae that may have detrimental effects on adolescent development. Potentially serious medical consequences and high comorbid rates of mood disorders and suicidality underscore the need for early recognition and effective treatments. Research among adolescents with BN has lagged behind that of adults, although evidence is accumulating to support the efficacy of family-based interventions and cognitive behavioral treatments that are adapted for use with adolescent populations. The aim of the current article is to provide an overview of recent research on epidemiology, risk factors, diagnostic issues, and treatment interventions focusing on adolescent BN, and to highlight areas for future research.

Psychosocial Factors Associated With Broadly Defined Bulimia Nervosa During Early Pregnancy: Findings from the Norwegian Mother and Child Cohort Study

The purpose of the present study was to investigate the relationship between psychosocial characteristics and broadly defined bulimia nervosa during early pregnancy, including factors associated with continuation, incidence and remission. A total of 41 157 women completed questionnaires at approximately gestation week 18, including items on eating disorders and psychosocial characteristics as a part of Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health. Incident bulimia nervosa during the first trimester was significantly associated with symptoms of anxiety and depression and low self-esteem and life satisfaction, whereas remission was significantly associated with higher self-esteem and life satisfaction. Continuation was not significantly related to any of the psychosocial variables tested. Onset of bulimia nervosa during pregnancy is associated with mood and anxiety symptoms. Remission of bulimic symptoms and new onset of bulimia nervosa are associated with opposite profiles of self-esteem, and life satisfaction measures.

Lifetime anxiety disorders in women with bulimia nervosa

We examined the prevalence and ages at onset of additional childhood and adult psychiatric disorders in women with bulimia nervosa and evaluated the differential impact of a mood or anxiety disorder on the presentation of bulimia nervosa. One hundred fourteen women participating in a clinical trial of cognitive-behavioral therapy for bulimia nervosa were assessed at pretreatment with structured diagnostic methodology. Although mood disorders were the most frequently occurring additional psychiatric disorder (75%), 64% experienced an additional anxiety disorder. Age at onset of the anxiety disorders was markedly earlier than age at onset of bulimia nervosa or other comorbid conditions. Stratification of the sample on the presence of a mood or anxiety disorder revealed no differences in the core bulimic symptoms across groups. The presence of a mood disorder was associated with greater body dissatisfaction, lower Global Assessment of Functioning Scales (GAFS) score, more externalizing disorders of childhood, and, as expected, higher Hamilton Depression Rating Scale (HDRS) scores. The presence of an anxiety disorder was related to a history of anorexia nervosa and earlier age at onset of drug or alcohol dependence. Early-onset anxiety disorders are prevalent and may represent one potential pathway to bulimia nervosa.

Childhood sexual abuse and bulimia nervosa: a comparison of American, Austrian, and Brazilian women

This study was designed to assess the prevalence of childhood sexual abuse among women with bulimia nervosa in three countries: the United States, Austria, and Brazil. In addition, it assessed whether bulimic subjects might have experienced more severe sexual abuse than women in the general population and whether bulimic subjects who report abuse might display greater psychopathology than those who do not report abuse. Thirty-three university students in Innsbruck, Austria, 33 university students in Boston, and 25 women in São Paulo, Brazil, all meeting DSM-III-R criteria for bulimia nervosa, were recruited by advertisement. Detailed histories of sexual abuse, obtained at the conclusion of a comprehensive evaluation interview, were prepared, translated into English, and rated by an investigator who was blind to the nationality of the subject. Subjects were compared on frequency of eating binges, history of major depression, body mass index, and satisfaction with body image. Narrowly defined childhood sexual abuse was reported by 24%-36% of women in the three countries, although only 15%-32% of women reported abuse before the onset of bulimia nervosa. There were no significant differences between countries in rates of abuse. Overall, these rates appear no greater than those reported in comparable studies of women in the general population. The data also did not support the hypothesis that bulimic subjects had endured more severe sexual abuse than other women, nor was there a significant association between history of childhood sexual abuse and severity of bulimic symptoms. These findings add to the weight of evidence suggesting that childhood sexual abuse is not a risk factor for bulimia nervosa.

Psychosocial Factors in the Origins of Bulimia Nervosa

Evidence is gathering that family disturbance precedes the onset of bulimia nervosa in a high proportion of cases presenting for treatment, however, this may be a general rather than a specific risk factor and may only be relevant in the subgroup with additionl personality disorder and depression. Serious life events and difficulties occurring shortly before onset are common in bulimic patients, but may be mediated by deficient coping skills and poor social support. The potential links between childhood care and adult eating disorder are discussed.