Marburg, Universiẗat, Diss., 2000.

No description available.

No description available.

AN ABSTRACT OF THE THESIS OF MICHELLE OSTIEN, for the Master of Science degree in FOOD AND NUTRITION, presented on November 20, 2008, at Southern Illinois University Carbondale. TITLE: SIMILARITIES AND DIFFERENCES IN FEMALES WITH REGARDS TO PERFECTIONISM IN THOSE WITH ANOREXIA NERVOSA, HIGH BMI (BINGE EATERS VS. NON-BINGE EATERS), AND THOSE SEEKING A HEALTHIER LIFESTYLE MAJOR PROFESSOR: Dr. Sharon Peterson One in five women in the United States struggle with an eating disorder or distorted eating patterns (National Institute of Mental Health, 2001). Perfectionism, one of the risk factors for developing an eating disorder, is a trait that many of these women have in common. While much research has been done on perfectionism in women with anorexia nervosa and bulimia nervosa, few studies have looked at perfectionism in women with binge eating disorder (Pratt, Telch, Labouvie, Wilson, & Agras, 2001). Our study sought to further understand the similarities and differences of the total and individual components of perfectionism in females seeking a healthier lifestyle, high BMI binge eaters, high BMI non-binge eaters, and anorexics. Our study found that the first component of the perfectionism scale (representing self-oriented perfectionism) was found to be significant between groups (p=0.002). When comparing females seeking a healthier lifestyle to high BMI binge eaters, females seeking a healthier lifestyle were more likely to answer "no", while high BMI binge eaters were more likely to answer "yes" (p=0.006). When comparing females seeking a healthier lifestyle to anorexics, females seeking a healthier lifestyle were more likely to answer "no" when compared to anorexics (p=0.033). When comparing high BMI binge eaters to high BMI non-binge eaters, high BMI binge eaters were also more likely to answer "yes" to this question when compared to high BMI non-binge eaters (p=0.048). Compared to 76.9% (N=10) of female anorexics, 74.4% (N=32) of female high BMI binge eaters, 50.0% (N=32) of female high BMI non-binge eaters, and 31.2 % (N=5) of females seeking a healthier lifestyle answered "yes" to perfectionism component one, which represented self-oriented perfectionism. Anorexics had the greatest tendency for perfectionism, followed by binge eaters, and then non-binge eaters. This study demonstrated that self-oriented perfectionism is the greatest indicator of perfectionism between subject groups and that perfectionism does exist in binge eaters.

Introduction: Defensive functioning may play an important role in the development and treatment of binge-eating disorder (BED). The Defense Mechanism Rating Scale (DMRS) is a widely used observer rating measure of defensive functioning. However, there is little research on defensive functioning and the DMRS in BED. This dissertation includes three studies on defensive functioning in individuals with BED. Study one assessed the validity and reliability of the DMRS when used to rate Adult Attachment Interview (AAI) transcripts, and compared defensive functioning between women with and without BED. Study two compared change in defensive functioning in women with BED who received Group Psychodynamic-Interpersonal Psychotherapy (GPIP) versus those in a waitlist no treatment control condition. Study three assessed the impact of other group therapy members’ defensive functioning on an individual group member’s treatment outcomes (i.e., binge-eating frequency and interpersonal functioning). Thus, the overall goals of this dissertation were to better understand the role of defensive functioning in BED, the degree to which defensive functioning changes due to group therapy, and the impact in the context of the therapy group’s defensive functioning on individual outcomes. Method: Participants with for this study were recruited from three previous investigations. Two clinical trials of group psychotherapy provided data of individuals with BED: (1) a randomized trial (N = 85) in which participants were assigned to GPIP (n = 35) or a waitlist control (n = 50), and (2) an uncontrolled study in which all participants with BED (N = 101) received GPIP. A total of 17 therapy groups were formed across both studies, with each group consisting of five to 11 members. In addition, a third study provided data from two comparison groups without BED: women who were overweight/obese (body mass index [BMI] > 27 kg/m2; n = 47) and women who were normal weight (BMI = 20 to 25 kg/m2; n = 49). Participants with BED completed a battery of questionnaires and the AAI at two time-points (i.e., pre-treatment/pre-waitlist and six months post-treatment/post-waitlist). Participants without BED completed the same battery of questionnaires and the AAI at one time-point and did not receive treatment. All AAI audio recordings were transcribed and used to code defensive functioning. Results: In study one, the DMRS coded from AAI transcripts demonstrated acceptable inter-rater reliability; good convergent validity, as it was significantly correlated with other related constructs (i.e., interpersonal functioning, reflective functioning, and attachment insecurity); and acceptable predictive validity, as women with BED had significantly lower defensive functioning than normal weight women without BED. In study two, those who received GPIP had significantly greater improvements in defensive functioning from pre-treatment to six months post-treatment compared to the waitlist control group. Follow-up analyses revealed that the average number of High Adaptive defenses significantly increased from pre-treatment to six months post-treatment in the GPIP condition, but not in the waitlist control condition; and significantly more participants assigned to the waitlist control condition deteriorated in their defensive functioning from pre-waitlist to six months post-waitlist than those assigned to GPIP. In study three, individual defensive functioning scores at pre-treatment were not significantly associated with either treatment outcome (i.e., binge-eating frequency or interpersonal distress) at six months post-treatment. However, other group members’ mean defensive functioning scores at pre-treatment were significantly associated with individual interpersonal distress, but not binge-eating frequency, at six months post-treatment. Discussion: Overall, this dissertation lends further support to the role of defensive functioning in the maintenance and treatment of BED. Individuals with BED tend to use less adaptive defensive functioning, but this can be improved through GPIP. Further, context of the therapy group in terms of defensive functioning is particularly important for improving treatment outcomes in individuals with BED. These findings should be replicated across more diverse samples and other types of group psychotherapy. Group therapists can help their patients with BED confront their maladaptive defense mechanisms and binge-eating by tackling their interpersonal distress, and placing sufficient emphasis on the group’s composition in terms of defensive functioning.

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No / Obese individuals, especially those who are morbidly obese, are more likely to binge-eat and to have Disinhibition, as measured by the Three Factor Eating Questionnaire of Stunkard and Messick (1985). The latter characterises very opportunistic eating behaviour and signifies a readiness to eat. We argue in this chapter that binge eating and Disinhibition are deeply adaptive as mechanisms for dealing with one of the most fundamental of insecurities, that of food, especially in seasonal and unpredictable environments. It is only in recent decades, with improved food security in industrialized nations and the emergence of obesity at the population level, that they have become maladaptive in terms of health outcomes, and have been medically pathologized. Binge-eating and Disinhibition are no longer responses to uncertainty in food availability has they would have been in the evolutionary past. Rather, there may be other types of uncertainty and insecurity that lead to Disinhibition, binge-eating and obesity, and clinical practice should perhaps turn to examining these as higher-level factors that structure health and illness. These would include stress at work and in everyday life

Objective: Weight bias has strong associations with psychopathology in overweight and obese individuals. However, self-evaluative processes, as conceptualized in the process model of self-stigma, and implications for other health-related outcomes, remain to be clarified. Design and Methods: In a representative general population sample of N = 1158 overweight and obese individuals, the impact of core self-evaluation as a mediator between weight bias internalization and mental and global health outcomes as well as between weight bias internalization and health care utilization, was examined using structural equation modeling. Results: In overweight and obese individuals, greater weight bias internalization predicted lower core self-evaluation, which in turn predicted greater depression and anxiety, lower global health, and greater health care utilization. These mediational associations were largely stable in subsample analyses and after controlling for sociodemographic variables. Conclusions: The results show that overweight and obese individuals with internalized weight bias are at risk for impaired health, especially if they experience low core self-evaluation, making them a group with which to target for interventions to reduce self-stigma. Weight bias internalization did not represent a barrier to health care utilization, but predicted greater health care utilization in association with greater health impairments.

Binge eating disorder is characterized by excessive consumption of highly palatable food within short periods of time accompanied by loss of control over eating. Extensive evidence provides support for the consideration of binge eating disorder as an addiction-like disorder. In this study, we wanted to determine whether rats undergoing an operant binge-like eating procedure could develop maladaptive forms of conditioned feeding behaviors. For this purpose, we trained male rats to self-administer either a sugary, highly palatable diet (Palatable rats) or a chow diet (Chow rats) for 1 hour/day. Following escalation and stabilization of palatable food intake, we tested both Chow and Palatable rats in a i) conditioned place preference, a ii) second-order schedule of reinforcement and, finally, a iii) cue-induced suppression of feeding. In the conditioned place preference task, Palatable rats spent significantly more time in the compartment which was paired with the palatable food when compared to Chow controls. Furthermore, in the second-order schedule of reinforcement task, Palatable rats exhibited active lever responding 4- to 6-fold higher than Chow control rats. Finally, in the conditioned suppression of feeding test, while Chow control subjects reduced responding by one-third in the presence of the conditioned punishment, Palatable rats persevered in responding despite the aversive cue. These results further characterize our animal model of binge-like eating and provide additional evidence for the addictive properties of highly palatable food.

Die Arbeit beschäftigt sich mit dem Nachweis eines Aufmerksamkeit-Bias auf visuelle Nahrungsreize bei Personen mit Binge-Eating-Störung, im Vergleich zu Personen ohne Essstörungssymptome via Eye-Tracking.