Faith-Anne Dohm

Comparison of Binge Eating Disorder and Bulimia Nervosa in a community sample

OBJECTIVE This study examined the relationship between binge eating disorder (BED), a newly proposed eating disorder, and bulimia nervosa (BN). METHOD Three groups recruited from the community were compared: women with BED (n = 150), women with purging BN (n = 48), and women with nonpurging BN (n = 14). RESULTS The three groups did not differ significantly in education, weight or shape concern, and current or lifetime prevalence of nine major mental disorders. Women with BED, compared with women with purging BN, were older, less likely to have a history of anorexia nervosa, and less likely to have been treated for an eating disorder. Obesity was more commonly associated with BED than with either subtype of BN. DISCUSSION Our results lend some support to BED as an eating disorder distinct from purging BN. More research is needed to clarify the position of nonpurging BN relative to BED and purging BN.

Toward an understanding of risk factors for Binge Eating Disorder in black and white women: A community-based case-control study

BACKGROUND This study sought to identify in white women risk factors specific to binge-eating disorder (BED) and for psychiatric disorders in general, and to compare black and white women on risk factors for BED. METHOD A case-control design was used. Participants were recruited from the community and included 162 women who met DSM-IV criteria for BED and two comparison groups of women with no history of clinically significant eating disorder symptoms. The comparison women were matched to BED women on age, education and ethnicity and divided into a healthy comparison (HC) group, who had no current psychiatric disorder, and a psychiatric comparison (PC) group, who had a diagnosis of a DSM-IV Axis I psychiatric disorder. The study sample size was determined by the group with the least members (PC), including 107 women with BED and 214 matched comparison women. A broad range of risk factors was assessed with a Risk Factor Interview and the Parental Bonding Instrument. RESULTS No significant effects for ethnicity by diagnostic group were found. BED women reported higher exposure to childhood obesity, family overeating or binge-eating, family discord, and high parental demands than PC women. The combined BED and PC group scored significantly higher than the HC group on measures of negative affect, parental mood and substance disorders, perfectionism, separation from parents, and maternal problems with parenting. CONCLUSIONS These findings indicate that childhood obesity and familial eating problems are reliable specific risk factors for BED. Ethnicity does not appear to moderate risk for BED.

Bias in Binge Eating Disorder: How representative are recruited clinic samples?

The aim of this study was to investigate sampling bias as it affects recruited clinic samples of binge eating disorder (BED). Demographic and clinical characteristics of a recruited clinic sample were compared with a community sample. The 2 groups met the same operational definition of BED and were assessed using the same primarily interview-based methods. Ethnicity, severity of binge eating, and social maladjustment were found to increase treatment seeking among participants with BED rather than levels of psychiatric distress or comorbidity. These findings suggest that previous studies using recruited clinic samples have not biased estimates of psychiatric comorbidity in BED.

Toward an understanding of risk factors for Anorexia Nervosa: A case-control study

BACKGROUND Prospective, longitudinal studies of risk factors for anorexia nervosa (AN) are lacking and existing cross-sectional studies are generally narrow in focus and lack methodological rigor. Building on two studies that used the Oxford Risk Factor Interview (RFI) to establish time precedence and comprehensively assess potential risk correlates for AN, the present study advances this line of research and represents the first case-control study of risk factors for AN in the USA. METHOD The RFI was used for retrospective assessment of a broad range of risk factors, while establishing time precedence. Using a case-control design, 50 women who met DSM-IV criteria for AN were compared to those with non-eating disorder DSM-IV psychiatric disorders (n=50) and those with no psychiatric disorder (n=50). RESULTS Women with psychiatric disorders reported higher rates of negative affectivity, maternal and paternal parenting problems, family discord, parental mood and substance disorder, and physical and sexual abuse than women with no psychiatric disorder. Women with AN specifically reported greater severity and significantly higher rates of negative affectivity, perfectionism and family discord, and higher parental demands than women with other psychiatric disorders. The role of weight and shape concerns was most salient in the year preceding onset of AN. CONCLUSIONS Convergent data identifying common risk factors as well as those more severe in the development of AN are emerging to inform longitudinal risk factor and prevention studies for this disorder.

Antecedent life events of binge-eating disorder

The present study investigated the occurrence of life events preceding the onset of disturbed eating in binge-eating disorder (BED). In a case-control design, 162 matched pairs of black and white women with BED and women with no current psychiatric disorder, and 107 matched pairs of women with BED and a current general psychiatric disorder were recruited from the community for the New England Womens Health Project. Life events in the year before the onset of disturbed eating were assessed retrospectively with an investigator-based interview. Women with BED reported exposure to a significantly greater number of life events during the year before onset of eating disturbances than both the non-psychiatric and psychiatric control women during the same period of time in their lives. Women with BED had a significantly higher risk of exposure to certain specific life events (e.g., critical comments about shape, weight, or eating; stress related to work, school or other sources; major changes in life circumstances and relationships; physical abuse; and feeling unsafe in a variety of settings) than the non-psychiatric control women, while differences between the BED and the psychiatric control group were less marked. There was no evidence for race-specific exposure to antecedent life events. The results suggest that a greater number and certain specific types of life events increase risk for the subsequent development of BED.

Risk factors across the eating disorders

This study sought to examine risk and onset patterns in anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). Women with AN (n=71), BN (n=66), BED (n=160) and non-psychiatric controls (n=323) were compared retrospectively on risk factors, symptom onset, and diagnostic migration. Eating disorder groups reported greater risk exposure than non-psychiatric controls. AN and BED differed on premorbid personality/behavioral problems, childhood obesity, and family overeating. Risk factors for BN were shared with AN and BED. Dieting was the most common onset symptom in AN, whereas binge eating was most common in BN and BED. Migration between AN and BED was rare, but more frequent between AN and BN and between BN and BED. AN and BED have distinct risk factors and onset patterns, while BN shares similar risk factors and onset patterns with both AN and BED. Results should inform future classification schemes and prevention programs.

Psychosocial and health consequences of adolescent depression in black and white young adult women

Depression in adolescent girls may result in negative consequences in young adulthood. The Center for Epidemiologic Studies Depression Scale (CES-D) was administered to 1,727 Black and White girls ages 16 to 18 years who participated in the National Heart, Lung, and Blood Institutes Growth and Health Study. Three years later, women in the depressed groups were more likely to be current smokers, had attained a lower level of education, and reported lower self-worth relative to the nondepressed group. Body dissatisfaction, eating concerns, and loneliness were greater in the depressed groups. Relative to Black women, White women who were moderately depressed during adolescence reported more health care services utilization in young adulthood. Prevention efforts for depressed adolescents should be broadly focused to improve young adult outcomes.

Factors differentiating women and men who successfully maintain weight loss from women and men who do not

The current study explored the relative contribution of exercise, coping responses, cognitive attributions, and emotional experiences to successful weight-loss maintenance in men and women. The data were collected via a large community-based survey on dieting and weight loss commissioned by Consumer Union. Men and women who met our criteria for successful (n = 277 men, n = 329 women) and unsuccessful (n = 277 men, n = 329 women) weight-loss maintenance were included in the sample. Successful weight-loss maintainers (Maintainers) reported having lost at least 10% of their highest adult weight and having maintained that weight loss for at least the three years immediately prior to the survey. Unsuccessful weight-loss maintainers (Regainers) reported not ever having been able to maintain a significant weight loss and having lost and regained a minimum of 10 to 19 pounds at least once. In response to a dietary lapse, Maintainers, as compared with Regainers, reported being more likely to use direct coping and less likely to seek help. The results imply that the most useful variables for differentiating between successful and unsuccessful weight-loss maintainers may involve how they respond to a dietary lapse.

Research mentoring and women in clinical psychology

The main question explored in this study is whether a womans choice to do research during her career as a clinical psychologist is associated with having had a research mentor. A sample of 616 women, all members of the American Psychological Association holding a Ph.D. in Clinical Psychology, completed a survey about their experience with a research mentor. The data show that research mentoring is positively related to a woman in clinical psychology doing research and whether she, in turn, becomes a research mentor for others. The responses of the participants suggest that a model of mentoring that involves relevant training and practical experience in research may increase the likelihood that female clinical psychologists will choose to do research as part of their careers.

Eating Disorders in Ethnic Minority Women: A Review of the Emerging Literature

This paper presents recent research on ethnic and cultural differences and similarities in disordered eating in diverse groups of women. Eating disorders present a significant problem among adolescent and young women in many Westernized countries and are associated with numerous physical and psychiatric problems. A common misconception has been that eating disorders are a disease of middle- or upper-class White females. However, a growing body of literature asserts that girls and women from ethnic minority populations are not immune to developing eating disorder symptoms or syndromes, although there are indications that prevalence estimates vary depending on the particular eating disorder symptom or syndrome under investigation and depending on the population being studied. Studies provide an initial indication that cultural factors may play a role in the etiology of eating disorders. We first review what currently is known about eating disturbances among diverse groups of women and then present research examining the role of culture and ethnicity in the detection and treatment of eating disorders. We conclude with a summary of avenues for future research and intervention.