Eytan Bachar

Food and emotion

The relationship between eating and emotion has always interested researchers of human behavior. This relationship varies according to the particular characteristics of the individual and according to the specific emotional state. We consider findings on the reciprocal interactions between, on the one hand, emotions and food intake, and, on the other, the psychological and emotional consequences of losing weight and dieting. Theories on the relationship between emotions and eating behaviors have their origin in the literature on obesity. The psychosomatic theory of obesity proposes that eating may reduce anxiety, and that the obese overeat in order to reduce discomfort. The internal/external theory of obesity hypothesizes that overweight people do not recognize physiological cues of hunger or satiety because of faulty learning. It thus predicts that normal weight people will alter (either increase or decrease) their eating when stressed, while obese people will eat regardless of their physiological state. The restraint hypothesis postulates that people who chronically restrict their food intake overeat in the presence of disinhibitors such as the perception of having overeaten, alcohol or stress. These theories are examined in the light of present research and their implications on eating disorders are presented.

An integrative quantitative model of factors influencing the course of anorexia nervosa over time

OBJECTIVEnTo identify factors influencing the course of anorexia nervosa (AN) over time.nnnMETHODnFormer female patients with AN (36 remitted and 24 nonremitted) and 31 healthy females responded to standardized interviews and self-rating questionnaires. Remitted patients maintained normal eating, normal weight, and regular menses for the past 12 months. Patients not fulfilling these criteria were considered nonremitted.nnnRESULTSnUsing logistic regression, we identified that number of hospitalizations, duration of ambulatory treatment, past vegetarianism, past anxiety, and childhood sexual abuse differentiated remitted from nonremitted patients, predicting nonremission. A similar analysis identified that elevated follow-up vegetarianism and eating-related concerns and lower body mass index (BMI) differentiated remitted from nonremitted patients, contributing to nonremission. Univariate analyses identified that remitted patients had elevated anxiety and eating-related obsessionality compared with the controls, suggesting these variables to potentially predispose to AN.nnnDISCUSSIONnElevated anxiety and eating-related obsessionality may increase the risk for the development of AN and for nonremission.

Anorexia nervosa and parental bonding: the contribution of parent-grandparent relationships to eating disorder psychopathology.

The present study adopted an intergenerational approach in examining the association between parental bonding and anorexia nervosa. Forty-three anorexic participants and 33 nonclinical comparison participants completed eating disorder questionnaires and the Parental Bonding Instrument (PBI). The participants parents also completed the PBI. The anorexic participants perceived both parents as less caring and fathers as more controlling than nonclinical participants. Among anorexic participants, mother control and father care were associated with symptom severity. Intergenerational effects were present. Among anorexic participants, maternal grandmother care was associated with eating disorder psychopathology. The present findings suggest that parental characteristics of grandparents might play a role in the development of eating disorders in granddaughters.

Adult patients' adjustability to orthodontic appliances. Part I: a comparison between Labial, Lingual, and Invisalign™.

This prospective study examined the adult patients perception of recovery after insertion of three types of orthodontic appliances: Buccal, Lingual and Invisalign. The sample consisted of sixty-eight adult patients (45 females and 23 males) who comprised three groups: 28 Buccal, 19 Lingual, and 21 Invisalign patients. After appliance insertion, patients completed a Health-Related Quality of Life questionnaire daily for the first week and again on day 14, in order to assess patients perception of pain and analgesic consumption. In addition, four areas of dysfunction were assessed: oral dysfunction, eating disturbances, general activity parameters, and oral symptoms. Lingual appliance was associated with more severe pain and analgesic consumption, the greatest oral and general dysfunction, and the most difficult and longest recovery. The Invisalign patients complained of relatively high levels of pain in the first days after insertion; however this group was characterized by the lowest level of oral symptoms and by a similar level of general activity disturbances and oral dysfunction compared to the Buccal appliance. Many Lingual and some Buccal patients did not reach a full recovery from their eating difficulties by the end of the study period. The present study provides information to adult patients and clinicians assisting them in choosing the most appropriate treatment modality in relation to Health-Related Quality of Life parameters.

Well being, psychopathology and coping strategies in psoriasis compared with atopic dermatitis: a controlled study

Backgroundu2002 There is a vast literature describing the association between psoriasis, atopic dermatitis (AD) and psychological distress. Some of these studies were uncontrolled and others used non‐dermatological diseases as control, but only a few used chronic skin diseases as controls.

Narcissistic vulnerability and the development of PTSD: a prospective study.

This study empirically examined the role of narcissistic traits and narcissistic vulnerability in the development of post-traumatic stress disorder (PTSD). One hundred forty-four survivors of a traumatic event were assessed 1 week, 1 month, and 4 months following the event. In the first-week assessment, patients were administered the Narcissistic Vulnerability Scale and self-reported rating scale to assess event severity and symptoms ensuing from the impact of the traumatic event: depression, intrusions, avoidance, and arousal. In the follow-up assessments, subjects were interviewed on the Clinician-Administered PTSD Scale and were readministered the self-rating symptoms scale. Survivors who developed acute (1 month) and chronic (4 months) PTSD had significantly higher levels of narcissistic vulnerability in the first-week assessment. Narcissistic Vulnerability Scale scores predicted PTSD status with sensitivity of 81.6% and 85.1% and specificity of 40.4% and 38.6% at the 1-month and 4-month assessments, respectively. Narcissistic vulnerabilities contribute to the occurrence of PTSD.

Childhood imaginary companionship and mental health in adolescence

An imaginary companion (IC) is a frequently encountered childhood fantasy, invisible to anyone but the child, who may be named, addressed or played with. Whether the presence of an IC is a normal developmental feature has not been determined. We examined psychometric measures and the presence/absence of childhood IC in a sample of 850 mentally healthy adolescents. 17.6% of our subjects, more often females, reported having had such a companion. Subjects who reported having had an IC in childhood exhibited higher levels of distress and emotional discontrol, displayed prolonged transitional object attachment and immature modes of coping with stress. Thus, although childhood imaginary companionship is not indicative of psychopathology, it may denote a vulnerability for adolescent perturbation and difficulty in coping with emotionally laden situations.

DEATH AND ANNIHILATION ANXIETIES IN ANOREXIA NERVOSA, BULIMIA, AND SELF-MUTILATION

Self-starvation, bulimic behavior, and self-mutilation comprise a triad of associated self-harm syndromes that are potentially life threatening, with anorexia nervosa having the highest mortality rate of any psychiatric disorder. They are associated with trauma and are extremely resistant to treatment. These patients present a disturbing lack of anxiety about their own life-threatening behavior, yet are preoccupied with death and anxiety about annihilation. Because dissociation compartmentalizes and separates psychological and somatic aspects of traumatic experience (psychological and somatoform dissociation), it enables these patients to disavow the life-threatening nature of their behavior, which makes the dissociative processes the most destructive factor in this psychopathology. The self-harm symptoms are a presymbolic form of communication that must be decoded and confronted in treatment to make recovery possible. For many patients who starve, purge, or mutilate themselves, the body is speaking of death. They require a treatment that protects their safety, determines their personal construct of death, treats the dissociative pathology and sadomasochism, and builds signal anxiety and other ego functions, especially affect regulation.

Childhood vs. Adolescence Transitional Object Attachment, and Its Relation to Mental Health and Parental Bonding

Abstract871 participants, 375 boys and 496 girls, mean age 16.7 + 1, were administered the Parental Bonding Instrument (P.B.I.), the Brief Symptom Inventory (B.S.I.), the General Well-Being Questionnaire (G.W.B.) and the Chestnut Lodge Transitional Object Scale. Results supported Winnicotts theory: participants reporting attachment to a Transitional Object (T.O.) in their childhood reported significantly more optimal maternal bonding than participants who were not attached to a T.O. Participants reporting attachment to a T.O. in adolescence had significantly more psychiatric symptoms and less general well-being. Adolescence T.O. attachment might be considered a marker of mental distress in the general, normal population.

Psychological well-being and ratings of psychiatric symptoms in bereaved Israeli adolescents: differential effect of war-versus accident-related bereavement.

Eight hundred seventy-one Israeli adolescents, 375 boys and 496 girls, mean age 16.7 +/- 1, participated in this study. Twenty-three of them lost relatives in war and 19 in road accidents. All participants were administered the Brief Symptom Inventory (BSI), the General Well-being Scale (GWB), the Parental Bonding Instrument (PBI) and the Perceived Social Support-Family/Friend (PSS-Fa and PSS-Fr) measures. War-bereaved adolescents showed significantly higher scores in psychological well-being (GWB) and significantly lower scores in reported psychiatric symptoms (BSI) than accident-bereaved adolescents. War-bereaved adolescents also had significantly better BSI and GWB scores than the general nonbereaved adolescent population. These results persisted after controlling for family socio-economic status, gender, and the degrees of closeness of the deceased relative. War-bereaved adolescents did not differ either from accident-bereaved adolescents or from the nonbereaved general adolescent population in social and family support systems (PSS-Fr, PSS-Fa) and did not experience different basic parental attitudes (PBI). Results are discussed in terms of the different meanings ascribed to death in battle versus death in a road accident.