Anne Hall

The factor structure of the eating disorder inventory in a patient setting

The factor structure of a multidimensional, clinically derived measure of the cognitive and behavioral characteristics of anorexia nervosa and bulimia, the Eating Disorder Inventory (EDI), was investigated in a patient setting. The results showed that eight factors corresponding to the eight original subscales of the EDI were clearly identified in the pattern of factor loadings and that they met conventional standards of internal consistency. The finding of an eight-factor solution using patient responses in this study contrasts with the finding of a clear three-factor solution in an earlier study that employed nonpatient responses. It is suggested that a difference may exist in the meaning of EDI items to patients and nonpatients. However, it is noted that there is a paucity of information in the eating disorders literature that addresses differences between these groups in their attitudes and beliefs regarding eating, weight, body shape, dieting, and self-esteem. This area is clearly one that warrants closer research attention by those working in the eating disorders.

The BULIT-R: its reliability and clinical validity as a screening tool for DSM-III-R bulimia nervosa in a female tertiary education population

The Bulimia Test (BULIT) has been updated to accommodate the DSM-III-R criteria for bulimia nervosa. Therefore, in this study, we evaluated the psychometric properties of the BULIT-R using a sample of young women at a tertiary educational institute. The results showed all 28 BULIT-R items correlated highly with the total test score (average = .59) and the internal reliability was high (.92). In terms of its concurrent validity, the BULIT-R correlated highly (.90) with the Bulimia Investigatory Test Edinburgh (BITE), a screening measure argued to detect bulimia nervosa. In terms of criterion-related validity, the optimal cutoff for the BULIT-R as a screening measure was 98 with this sample, using a semistructured DIS-III R interview administered by experienced clinicians who specialize in eating disorders. At this cutoff, the sensitivity was 100%, the specificity 99.0%, the negative predictive value 100%, and the positive predictive value 71.3%.

Anorexia nervosa in the male: Clinical features and follow-up of nine patients

Nine male patients formed approximately 5% of patients presenting with anorexia nervosa from a population area. Their clinical and family features and outcome at a mean of 5 1/2 yr from onset were similar to those of female patients. All patients lost libido during the syndrome. In four patients at average weight at follow-up the level of libido and sexual activity was related to testosterone level, other hormonal investigations being normal in post pubertal patients. All patients had a history of increased attention to bodily appearance and/or diet before the onset of the illness (e.g. aberrant body size or appearance, close contact with an eating disorder patient).

Investigation of Osteopaenia in Anorexia Nervosa

Sixty-nine female patients, mean age 27.5 years (range 20-40), with a past or current history of anorexia nervosa (DSM Ill-R) had spinal trabecular bone density assessed by single energy quantitative CT scan. Current exercise and dietary calcium levels were assessed by detailed questionnaires and categorized. A semi-structured interview was used to record weight, menstruation, exercise and dietary calcium intake histories from early adolescence. Serum sex hormones and total calcium assays were measured. Bone density was significantly lower in the patients compared to 31 controls. Bone density was significantly positively correlated with body mass index, and negatively correlated with illness duration and duration of amenorrhoea. Exercise levels, dietary calcium intake and taking an oestrogen pill did not correlate significantly with bone density. Recovered patients did not have osteopaenia but they had shorter illness histories than non-recovered patients. Management to minimise bone loss should focus on weight gain and resumption of normal menstruation.

ANOREXIA NERVOSA IN THE MALE: CLINICAL FEATURES AND FOLLOW-UP OF NINE PATIENTS

Nine male patients formed approximately 5% of patients presenting with anorexia nervosa from a population area. Their clinical and family features and outcome at a mean of 51/2; yr from onset were similar to those of female patients. All patients lost libido during the syndrome. In four patients at average weight at follow-up the level of libido and sexual activity was related to testosterone level, other hormonal investigations being normal in post pubertal patients. All patients had a history of increased attention to bodily appearance and/or diet before the onset of the illness (e.g. aberrant body size or appearance, close contact with an eating disorder patient).