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Five Years After Child Sexual AbuseSwanston, Heather Yvette January 2000 (has links)
Introduction Child sexual abuse is a common problem. Psychological and behavioural problems in children and adults who have experienced child sexual abuse have been associated with the abuse. Little research has been conducted which has been long-term, prospective, involved substantiated sexual abuse, included a control group, took into account mediating factors, utilised multiple data sources, relied on standardised measures and had a high follow-up rate. Aim The aims of this study were to compare a cohort of sexually abused young people with a group of nonabused peers and to establish predictors of psychological and behavioural outcome. Method This study was a follow-up which was long-term, prospective, involved a sample of children with substantiated sexual abuse, included a control group, took into account mediating factors, utilised multiple data sources, relied on standardised measures and had a high follow-up rate. Eighty-four sexually abused young people were followed up five years after presenting to Children�s Hospitals� Child Protection Units for sexual abuse and were compared to a group of 84 nonabused young people of similar age and sex. The two groups were compared on the basis of demographic variables, family functioning, mother�s mental health and life events; the outcome measures of depression, self-esteem, anxiety, behaviour, criminal activity, alcohol and other drug use, eating problems, running away, suicide attempts, self-injury, hopefulness, despair and attributional style; and potential mediating factors such as further notifications to the Department of Community Services, receipt of psychological treatment, legal action against offenders and victims compensation. Potential predictors of outcome were (1) demographic variables, (2) sexual abuse characteristcs, (3) intake data and (4) five year follow-up variables. Main findings Follow-up rates were 81percent (n equals 68) for cases and 89percent (n equals 75) for controls. Five years after presenting for the sexual abuse, the sexually abused young people were performing more poorly than their nonabused peers on various measures of psychological state and behaviour. Although the abused children had experienced more negative life events (p<.001), were from lower socio-economic groups (p<.0001), had more changes in parent figures (p<.001) and had mothers who were more psychologically distressed (p equals .03), multiple regression analysis showed that after allowing for these and other demographic and family factors, there were still significant differences between the groups after the 5 years. The abused children displayed more disturbed behavior (p equals .002), had lower self-esteem (p<.001), were more depressed or unhappy (p<.001) and were more anxious (p equals .03) than controls. Sexually abused children had significantly higher levels of bingeing (p equals .02), self-injury (p equals.009) and suicide attempts (p equals .03). Significant predictors of psychological and behavioural outcome were significantly related to family and parent functioning variables. Abuse status was not a significant predictor when offered to each of the predictive models. Significant predictors of outcome included the following intake variables: family functioning, mother�s mental health, whether parents were employed or not, behaviour scores, prior notifications for neglect, history of parental discord and whether there were caregiver changes or not prior to intake. The classification of the index sexual abuse event as indecent assault and whether there were notifications for sexual abuse prior to the index event also significantly predicted outcome. Five year follow-up variables which were significant predictors of outcome were the young person�s age, number of negative life events, attributional style, self-esteem, depression, number of parent changes, anxiety, despair, whether there were notifications for abuse/neglect after intake and having a parent with a history of drug/alcohol problems. Conclusions Difficulties associated with child sexual abuse continue for some years after the abuse event. Child sexual abuse needs to be considered as a possible antecedent of behaviour and psychological difficulties in young people. Treatment and monitoring should continue for some years after the abuse. Treatment may need to be directed more towards young people�s psychological states rather than focusing specifically on the sexual abuse. Family and parent functioning may need to be addressed early in order to prevent some of the behavioural and psychological difficulties associated with the long-term outcome of child sexual abuse.
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Efeito dos polimorfismos nos genes da leptina e do receptor da leptina sobre a compulsão alimentar em crianças e adolescentes obesos / Effect of polymorphisms in the leptin and leptin receptor genes on binge eating in obese children and adolescentsClarissa Tamie Hiwatashi Fujiwara 31 July 2014 (has links)
INTRODUÇÃO: A obesidade na infância e adolescência representa uma epidemia global e figura como um problema de saúde pública proeminente de prevalência crescente. A obesidade frequentemente está associada à compulsão alimentar periódica (CAP) e componentes genéticos participam de sua etiologia multifatorial. Polimorfismos de nucleotídeo único (SNPs) no gene da leptina (LEP) e do receptor da leptina (LEPR) podem modificar a expressão da leptina e de suas vias de sinalização e, consequentemente, alterar a regulação do apetite e da saciedade, contribuindo assim para a etiopatogenia e manutenção da CAP. O objetivo deste trabalho foi investigar a influência dos polimorfismos rs7799039 (G > A) no gene LEP e rs1137100 (A > G), rs1137101 (A > G) e rs8179183 (G > C) no gene LEPR sobre a CAP em crianças e adolescentes obesos, além de caracterizar a população quanto à CAP e verificar a associação dos SNPs com o risco cardiometabólico (RCM) e a obesidade. MÉTODOS: Estudo transversal que incluiu 465 crianças e adolescentes obesos com idade entre 7 e 19 anos avaliados quanto a variáveis antropométricas e metabólicas. Os fatores de RCM consistiram de hipertensão arterial sistêmica, glicemia de jejum alterada, HDL-colesterol baixo e hipertrigliceridemia. A CAP foi avaliada por meio da Escala de Compulsão Alimentar Periódica (ECAP). Para investigar o efeito dos SNPs no risco para a obesidade foi incluído um grupo controle composto por 135 crianças e adolescentes eutróficos. A genotipagem foi realizada por PCR em tempo real e para análise dos SNPs, adotou-se o modelo dominante. Foi calculado o desequilíbrio de ligação entre os SNPs e estimada as frequências dos haplótipos. As comparações entre os grupos foram realizadas estratificadamente por gênero e estádio puberal. Para avaliar a magnitude do risco dos SNPs sobre a CAP e a obesidade foi realizada regressão logística ajustada para variáveis de confusão (idade, Z-IMC e estádio puberal). RESULTADOS: As crianças e adolescentes obesos (12,5 ± 2,9 anos; 52,7% meninas) classificados com CAP apresentaram maior adiposidade e a frequência da CAP foi mais elevada no gênero feminino (OR= 2,146; IC 95% 1,461-3,152; p < 0,001). A frequência do alelo A do rs7799039 foi mais elevada no grupo de obesos (OR= 1,530; IC 95% 1,022-2,292; p= 0,039) e o alelo associou-se ao maior nível de leptina e colesterol total em meninas e à maior glicemia em meninos (p < 0,05). No rs1137100 e o rs1137101, a presença do alelo G em meninas conferiu risco para a hipertrigliceridemia (OR= 1,926; IC 95% 1,010-3,673; p= 0,047 e OR= 2,039; IC 95% 1,057-3,931; p= 0,033, respectivamente). O alelo C do rs8179183 relacionou-se, em meninas, à relação cintura-estatura e glicemia mais elevadas e, em meninos, ao maior percentil de pressão arterial diastólica, glicemia, colesterol total e LDL-colesterol (p <0,05). CONCLUSÃO: Os polimorfismos não foram associados à compulsão alimentar periódica. A CAP foi relacionada ao pior grau de adiposidade e o maior risco foi observado no gênero feminino. O SNP rs7799039 no gene LEP conferiu risco para obesidade, enquanto o rs1137100, rs1137101 e rs8179183 no gene LEPR relacionaram-se ao pior perfil cardiometabólico em crianças e adolescentes obesos / INTRODUCTION: Obesity during childhood and adolescence represents a global epidemic and consists in a prominent public health issue of increasing prevalence. Obesity is frequently associated with binge eating (BE) and genetic factors participate of its multifactorial etiology. Single nucleotide polymorphisms (SNPs) in the leptin (LEP) and leptin receptor (LEPR) genes may modify the leptin expression and its signaling pathways and, consequently, alter appetite and satiety regulation, thus contributing to the etiopathogeny and maintenance of BE. The aim of this study was to investigate the influence of polymorphisms rs7799039 (G > A) in the LEP gene and rs1137100 (A > G), rs1137101 (A > G) and rs8179183 (G > C) in the LEPR gene on BE in obese children and adolescents, besides characterize the population regarding to BE and examine the association of SNPs with cardiometabolic risk (CMR) and obesity. METHODS: Cross-sectional study in which 465 obese children and adolescents aged from 7 to 19 years were enrolled and had anthropometric and metabolic variables assessed. The CMR factors consisted of systemic hypertension, impaired fasting glucose, low HDL-cholesterol levels and hypertriglyceridemia. The BE was evaluated through the Binge Eating Scale (BES). To investigate the effect of SNPs on obesity risk, a control group of 135 eutrophic children and adolescents was enrolled. Genotyping was performed by real-time PCR and for the SNPs analysis, the dominant model was adopted. The linkage disequilibrium between SNPs was calculated and the haplotype frequencies were estimated. Comparisons between groups were performed stratified by gender and pubertal stage. To assess the risk magnitude for the SNPs on BE and obesity, logistic regression adjusted for confounding variables (age, Z-BMI and pubertal stage) was performed. RESULTS: Obese children and adolescents (12.5 ± 2.9 years, 52.7% girls) classified with BE showed greater adiposity and BE frequency was higher among females (OR= 2.146; 95% CI 1.461-3.152; p < 0.001). The observed frequency of A allele of rs7799039 was a higher in the obese group (OR= 1.530; 95% CI 1.022-2.292; p= 0.039) and the allele was associated with higher leptin and total cholesterol levels in girls and higher glucose levels in boys (p < 0.05). For the rs1137100 and rs1137101, the presence of the G allele among girls, conferred risk for hypertriglyceridemia (OR= 1.926; 95% CI 1.010-3.673; p= 0.047 and OR= 2.039; 95% CI 1.057-3.931; p= 0.033, respectively). The C allele of rs8179183 was associated, among girls, with a higher waist-to-height ratio and glucose levels and, among boys, with greater diastolic blood pressure percentile, glucose, total cholesterol and LDL-cholesterol levels (p < 0.05). CONCLUSION: Polymorphisms were not associated with binge eating. BE was related with a more severe adiposity and an increased risk was observed among females. The SNP rs7799039 in the LEP gene contributed to the risk of obesity, whereas the rs1137100, rs1137101 and rs8179183 in LEPR gene were related to a worse cardiometabolic profile in obese children and adolescents
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Cognitive and emotional functioning in BEDKittel, Rebekka, Brauhardt, Anne, Hilbert, Anja January 2015 (has links)
Objective: Binge-eating disorder (BED) is characterized by recurrent episodes of binge eating and is associated with eating disorder and general psychopathology and overweight/obesity. Deficits in cognitive and emotional functioning for eating disorders or obesity have been reported. However, a systematic review on cognitive and emotional functioning for individuals with BED is lacking.
Method: A systematic literature search was conducted across three databases (Medline, PubMed, and PsycINFO). Overall, n = 57 studies were included in the present review.
Results: Regarding cognitive functioning, individuals with BED consistently demonstrated higher information processing biases compared to obese and normal-weight controls in the context of disorder-related stimuli (i.e., food and body cues), whereas cognitive functioning in the context of neutral stimuli appeared to be less affected. Thus, results suggest disorder-related rather than general difficulties in cognitive functioning in BED. With respect to emotional functioning, individuals with BED reported difficulties similar to individuals with other eating disorders, with a tendency to show less severe difficulties in some domains. In addition, individuals with BED reported greater emotional deficits when compared to obese and normal-weight controls. Findings suggest general difficulties in emotional functioning in BED. Thus far, however, investigations of emotional functioning in disorder-relevant situations are lacking.
Discussion: Overall, the cross-sectional findings indicate BED to be associated with difficulties in cognitive and emotional functioning. Future research should determine the nature of these difficulties, in regards to general and disorder-related stimuli, and consider interactions of both domains to foster the development and improvement of appropriate interventions in BED.
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Weight bias internalization, emotion dysregulation, and non-normative eating behaviors in prebariatric patientsBaldofski, Sabrina, Rudolph, Almut, Tigges, Wolgang, Herbig, Beate, Jurowich, Christian, Kaiser, Stefan, Dietrich, Arne, Hilbert, Anja January 2015 (has links)
Objective: Weight bias internalization (WBI) is associated with eating disorder psychopathology and non-normative eating behaviors among individuals with overweight and obesity, but has rarely been investigated in prebariatric patients. Based on findings demonstrating a relationship between emotion dysregulation and eating behavior, this study sought to investigate the association between WBI and eating disorder psychopathology as well as non-normative eating behaviors (i.e., food addiction, emotional eating, and eating in the absence of hunger), mediated by emotion dysregulation.
Method: Within a consecutive multicenter study, 240 prebariatric patients were assessed using self-report questionnaires. The mediating role of emotion dysregulation was examined using structural equation modeling.
Results: The analyses yielded no mediational effect of emotion dysregulation on the association between WBI and eating disorder psychopathology. However, emotion dysregulation fully mediated the associations between WBI and emotional eating as well as eating in the absence of hunger. Further, emotion dysregulation partially mediated the relationship between WBI and food addiction symptoms.
Discussion: Prebariatric patients with high levels of WBI are at risk for non-normative eating behaviors, especially if they experience emotion regulation difficulties. These findings highlight the importance of interventions targeting WBI and improving emotion regulation skills for the normalization of eating behavior in prebariatric patients.
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Implicit cognitive processes in binge-eating disorder and obesityBrauhardt, Anne, Rudolph, Almut, Hilbert, Anja January 2014 (has links)
Objectives: Binge-eating disorder (BED) is characterized by recurrent binge eating episodes, associated eating disorder and general psychopathology, and commonly occurs in obese individuals. Explicit self-esteem and explicit weight bias have been linked to BED, while little is known about implicit cognitive processes such as implicit self-esteem and implicit weight bias.
Methods: Obese participants with BED and an individually matched obese only group (OB) and normal weight control group (CG; each N = 26) were recruited from the community to examine group differences and associations in explicit and implicit self-esteem and weight bias, as well as the impact of implicit cognitive processes on global eating disorder psychopathology. Implicit cognitive processes were assessed using the Implicit Association Test.
Results: Significantly lower explicit self-esteem, as well as higher exposure to explicit weight bias, compared to CG and OB was found in the BED group. All groups showed positive implicit self-esteem, however, it was significantly lower in BED when compared to CG. BED and CG demonstrated equally high implicit weight bias whereas OB did not. Explicit and implicit measures were not significantly correlated. Global eating disorder psychopathology was predicted by explicit and implicit self-esteem.
Conclusions: The results of the present study add to the importance of implicit self-esteem and implicit weight bias beyond explicit measures in BED, while both were previously shown to be associated with onset and maintenance of BED. In conclusion, implicit cognitive processes should be focused on in interventions for BED to investigate their impact on psychological treatments.
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Therapist adherence in individual cognitive-behavioral therapy for binge-eating disorder: assessment, course, and predictorsBrauhardt, Anne, de Zwaan, Martina, Herpertz, Stephan, Zipfel, Stephan, Svaldi, Jennifer, Friederich, Hans-Christoph, Hilbert, Anja January 2014 (has links)
While cognitive-behavioral therapy (CBT) is the most well-established treatment for binge-eating disorder (BED), little is known about process factors influencing its outcome. The present study sought to explore the assessment of therapist adherence, its course over treatment, and its associations with patient and therapist characteristics, and the therapeutic alliance.
In a prospective multicenter randomized-controlled trial comparing CBT to internet-based guided self-help (INTERBED-study), therapist adherence using the newly developed Adherence Control Form (ACF) was determined by trained raters in randomly selected 418 audio-taped CBT sessions of 89 patients (25% of all sessions). Observer-rated therapeutic alliance, interview-based and self-reported patient and therapist characteristics were assessed. Three-level multilevel modeling was applied.
The ACF showed adequate psychometric properties. Therapist adherence was excellent. While significant between-therapist variability in therapist adherence was found, within-therapist variability was non-significant. Patient and therapist characteristics did not predict the therapist adherence. The therapist adherence positively predicted the therapeutic alliance.
The ACF demonstrated its utility to assess therapist adherence in CBT for BED. The excellent levels of therapist adherence point to the internal validity of the CBT within the INTERBED-study serving as a prerequisite for empirical comparisons between treatments. Variability between therapists should be addressed in therapist trainings and dissemination trials.
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Subliminal and supraliminal processing of reward-related stimuli in anorexia nervosaBoehm, I., King, J. A., Bernardoni, F., Geisler, D., Seidel, M., Ritschel, F., Goschke, T., Haynes, J.-D., Roessner, V., Ehrlich, S. 04 June 2020 (has links)
Background. Previous studies have highlighted the role of the brain reward and cognitive control systems in the etiology of anorexia nervosa (AN). In an attempt to disentangle the relative contribution of these systems to the disorder, we used functional magnetic resonance imaging (fMRI) to investigate hemodynamic responses to reward-related stimuli presented both subliminally and supraliminally in acutely underweight AN patients and age-matched healthy controls (HC).
Methods. fMRI data were collected from a total of 35 AN patients and 35 HC, while they passively viewed subliminally and supraliminally presented streams of food, positive social, and neutral stimuli. Activation patterns of the group × stimulation condition × stimulus type interaction were interrogated to investigate potential group differences in processing different stimulus types under the two stimulation conditions. Moreover, changes in functional connectivity were investigated using generalized psychophysiological interaction analysis.
Results. AN patients showed a generally increased response to supraliminally presented stimuli in the inferior frontal junction (IFJ), but no alterations within the reward system. Increased activation during supraliminal stimulation with food stimuli was observed in the AN group in visual regions including superior occipital gyrus and the fusiform gyrus/parahippocampal gyrus. No group difference was found with respect to the subliminal stimulation condition and functional connectivity.
Conclusion. Increased IFJ activation in AN during supraliminal stimulation may indicate hyperactive cognitive control, which resonates with clinical presentation of excessive self-control in AN patients. Increased activation to food stimuli in visual regions may be interpreted in light of an attentional food bias in AN.
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Régulation émotionnelle et conduites alimentaires à risque : approfondissement du rôle de l’alexithymie et des émotions discrètes de types traits et étatsPugliese, Jessica 09 1900 (has links)
La forte prévalence des conduites alimentaires à risque (CAAR), par exemple la restriction alimentaire, les vomissements auto-induits ainsi que les crises d’hyperphagie boulimique de sévérité non diagnostique, et les conséquences importantes qu’elles peuvent entraîner ont amené les chercheurs à vouloir mieux comprendre les facteurs impliqués dans leur développement. Cette thèse s’intéresse à un phénomène à la base d’un nombre grandissant de théories sur les CAAR : la régulation émotionnelle. Le premier article se concentre sur le concept d’alexithymie, un trait de personnalité jouant un rôle clé dans la régulation émotionnelle ainsi que le développement, le maintien et la rechute des CAAR. Bien que l’association entre l’alexithymie et les CAAR soit bien établie, les études n’offrent pas d’explication quant aux facteurs qui contribuent à l’apparition de traits de personnalité alexithymiques qui, à leur tour, placent l’individu à risque de développer des CAAR. En explorant la documentation scientifique disponible, il est possible de constater que plusieurs psychanalystes ont autrefois proposé des concepts pour expliquer le développement de l’alexithymie (p. ex. refoulement primaire, expérience non formulée, déni), mais ces théories ont rarement fait l’objet d’études empiriques. L’objectif du premier article est donc de tester ces modèles en utilisant deux stratégies de régulation émotionnelle provenant du modèle de James J. Gross, soit la suppression expressive et la réévaluation cognitive. Un échantillon de 292 femmes provenant majoritairement d’une population non clinique universitaire a complété le Toronto Alexithymia Scale-20 items, le Emotion Regulation Questionnaire et le Eating Disorder Inventory-2. Les résultats des médiations proposent que la suppression expressive prédit positivement les traits de personnalité alexithymiques, ce qui prédit positivement les CAAR. Inversement, la réévaluation cognitive prédit négativement les traits de personnalité alexithymiques, ce qui prédit ensuite négativement les CAAR. Ces résultats suggèrent qu’il pourrait être pertinent d’intervenir sur certains mécanismes potentiellement précurseurs de l’alexithymie afin de favoriser la diminution d’agirs comportementaux comme les CAAR. Les résultats de cette première étude ouvrent la réflexion sur des pistes d’intervention concrètes pouvant être mises en application auprès des personnes souffrant de CAAR. En effet, les résultats de cette thèse suggèrent qu’il pourrait être important d’aider l’individu à diminuer l’évitement/la suppression de ses émotions pour plutôt encourager leur exploration. Il est possible d’émettre l’hypothèse que ce type d’intervention permettrait, avec le temps, la diminution des traits alexithymiques, ceci en favorisant la formation de représentations mentales des émotions. Conséquemment, la diminution de décharges somatiques comme les CAAR pourrait s’en suivre. L’implication des résultats pour les thérapies de différentes approches (p.ex. psychodynamique, cognitivo-comportementale et basée sur la mentalisation) est ensuite discutée.
Afin de préciser l’étude de la régulation émotionnelle dans les CAAR, le second article a pour but d’identifier les émotions jouant un rôle particulier au sein de ces comportements. Pour ce faire, cet article, qui comprend deux études, s’intéresse aux liens entre les catégories émotionnelles distinctes du modèle des émotions différentielles d’Izard (p. ex. tristesse, joie) et les CAAR. La première étude a pour objectif d’explorer l’association entre les émotions-traits et les conduites alimentaires de recherche de minceur et boulimiques. Un total de 244 femmes provenant en majorité d’une population non clinique universitaire a complété le Eating Disorder Inventory-2 et le Differential Emotion Scale-trait version. Les analyses de régression démontrent que le modèle d’Izard prédit significativement les conduites de recherche de minceur et boulimiques. La contribution unique de chaque émotion-trait est ensuite étudiée. Les résultats indiquent que la honte est la seule émotion qui reste un prédicteur significatif des conduites de recherche de minceur et que seuls la culpabilité, le mépris et l’hostilité dirigée contre soi demeurent des prédicteurs significatifs des comportements boulimiques. Pour sa part, la seconde étude a pour but d’explorer l’association entre les émotions-états et les CAAR. Un total de 155 participantes provenant de l’échantillon de la première étude a complété un questionnaire leur demandant de rapporter par écrit un comportement de restriction ou de boulimie ayant eu lieu dans le passé. Elles ont ensuite complété le Differential Emotion Scale-state version. Les analyses descriptives démontrent que nonobstant la nature du comportement, la tristesse est l’émotion vécue la plus intensément par les participantes avant l’épisode rapporté. De plus, une comparaison de groupes a révélé que les personnes ayant décrit un épisode de boulimie ressentent significativement moins de joie et d’intérêt avant l’épisode que celles ayant rapporté un comportement restrictif. En résumé, les résultats suggèrent tout d’abord que les émotions négatives semblent jouer un rôle important au sein des CAAR. En ce sens, cet article appuie les recommandations de certains chercheurs à l’effet que l’intervention auprès des personnes ayant des CAAR nécessite d’inclure des volets dédiés à la régulation des émotions. Toutefois, ces études vont encore plus loin en proposant qu’il pourrait être pertinent de développer des interventions ciblées et concrètes permettant la gestion d’émotions ou de patrons d’émotions qui jouent un rôle prédominant auprès des différents CAAR. / The high prevalence of disordered eating (DE), for example food restriction, selfinduced
vomiting or binge eating that are not of diagnostic severity, and the important
consequences that they can entail have led researchers to further investigate the premorbid
factors involved in them. The present thesis is interested in a phenomenon that is the basis of a
growing body of theories on DE: emotion regulation. The first paper focuses on the concept of
alexithymia, a personality trait that plays a key role in emotion regulation as well as in the
development, maintenance, and relapse of DE symptoms. Although the association between
alexithymia and DE is well established, current studies offer no explanation as to what factors
contribute to the development of alexithymic personality traits, which in turn puts the individual
at risk for DE. Several psychoanalysts have offered theoretical concepts to explain the
development of alexithymia (e.g. primary repression, unformulated experience, denial), but these
have not been submitted to empirical studies. The aim of the first study is to test these theories
using two empirically established emotion regulation strategies taken from James J. Gross's
model, namely expressive suppression and cognitive reappraisal. A sample of 292 women, the
majority being undergraduated students, completed the Toronto Alexithymia Scale-20 items, the
Emotion Regulation Questionnaire, and the Eating Disorder Inventory-2. The results of the
mediation analyzes suggest that expressive suppression significantly and positively predicts
alexithymic personality traits, which positively predicts DE. Inversely, cognitive reappraisal
negatively predicts alexithymic personality traits, which then negatively predicts DE. These
results suggest that it could be important to intervene on certain mechanisms that are potential
precursors of alexithymia in order to promote the reduction of DE. More specifically, the results
of this first study open up reflection on concrete lines of intervention that could be applied to
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people suffering from DE. Indeed, the results propose that it could be beneficial to encourage
these individuals to explore their emotions rather then to avoid / suppress them. It can be
hypothesised that these types of intervention will allow, over time, the reduction of alexithymic
traits by promoting the formation of mental representations of emotions. Consequently, it is
possible that the decrease in somatic discharges such as DE will follow. The implication of the
results for different therapeutic approaches (psychodynamic, cognitive behavioral and
mentalization-based) is then discussed.
In order to further clarify the role of emotional regulation in DE, the second paper aims to
identify emotions that play a key role in the disorder. This article, divided into two studies,
focuses on the association between distinct emotional categories from Izard's differential
emotions theory (e.g. sadness, joy) and pathological eating. The first study explores the
relationship between trait-emotions and DE. A total of 244 women, the greater part being
undergraduated students, completed the Eating Disorder Inventory-2 and the Differential
Emotion Scale-trait version. Regression analyzes show that Izard's model significantly predicts
both drive for thinness and bulimic behaviors. The unique contribution of each trait-emotion is
then explored. The results indicate that shame is the only emotion that remains a significant
predictor of drive for thinness and that only guilt, contempt and self-directed hostility remain
significant predictors of bulimic behavior. As for the second study, a total of 155 participants
coming from the first study sample completed a questionnaire asking them to report in writing an
episode of restriction or bulimia that occurred in the recent past. They then completed the
Differential Emotion Scale-state version. Descriptive analyzes reveal that regardless of the kind
of DE, sadness is the emotion experienced most intensely by the participants before the reported
episode. Furthermore, group comparisons indicate that people who report a bulimic episode felt
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significantly less joy and interest before the event than those who recalled a restrictive behavior.
In summary, the results first suggest that people with DE experience more negative emotions on
a daily basis. Thereby, this article supports the recommendations of certain researchers
suggesting that interventions with people exhibiting DE should include components dedicated to
the regulation of emotions. Moreover, these studies go even further by suggesting that it could be
relevant to develop targets and concrete interventions allowing the regulation of specific
emotions or patterns of emotions, which could play a predominant role with the various DE.
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Riesgo de trastornos de la conducta alimentaria y comportamiento alimentario inadecuado en estudiantes de la carrera de nutrición y dietética de una universidad privada de Lima / Eating disorder risk and disordered eating behaviour in nutrition and dietetics students of a private university in LimaParedes Vargas, Jodie Ximena, Chau Miyakawa, Kiara Lorena Harumi 21 February 2021 (has links)
Esta investigación busca determinar la asociación entre el riesgo de trastornos de la conducta alimentaria (TCA) y el comportamiento alimentario en estudiantes de nutrición y dietética de una universidad privada de Lima. A 264 estudiantes se les aplicó una encuesta sobre sus datos personales y los cuestionarios EAT-26 y TFEQ-r21. Se utilizaron la prueba de Chi cuadrado para para analizar la asociación entre las variables categóricas y la prueba de t de student para variables numéricas. Del total de estudiantes incluidos en el estudio, el 18,2% presentó riesgo de padecer TCA. El mayor riesgo fue encontrado en estudiantes de segundo año de la carrera y el menor riesgo en los de último año (p=0,048). De las 3 subescalas del cuestionario TFEQ-r21, “restricción cognitiva” fue la subescala con las puntuaciones más altas, indicando alto riesgo a tener comportamiento alimentario inadecuado en estudiantes de ambos sexos con un promedio de 2,93(DE:0,45; p<0,001). Se encontraron asociaciones positivas entre el riesgo de padecer TCA con el peso corporal (p=0,027), el autorreporte de residencia en mujeres (no vivir con familia) (p=0,013) y con la no omisión de comidas en hombres (p=0,010). En conclusión, se encontró alta prevalencia de riesgo de padecer TCA, sobretodo en los estudiantes de segundo año académico y de sexo femenino en la carrera de nutrición y dietética. Además, se encontró una alta tendencia a la restricción cognitiva en los estudiantes de la carrera. Debe haber mayor conciencia y preocupación por prevenir, detectar y abordar los TCA en los estudiantes de nutrición, puesto que los TCA no sólo pueden afectar su salud física y mental, sino también su criterio profesional a futuro. / The aim of this research is to determine the association between eating disorder risk and disordered eating behaviour in students of the career of nutrition and dietetics of a private university in Lima. A survey of personal information and two questionnaires: EAT-26 and TFEQ-r21 were applied to 264 students. The Chi-square test was used to analyze the association between categorical variables and the Student’s t-test for numerical variables. Of the total of students included in the study, 18,2% presented a risk of suffering from eating disorders; the highest risk was found in second-year students of the degree and the lowest risk in seniors (p=0,048). Of the 3 subscales of the TFEQ-r21 questionnaire, “cognitive restriction” was the subscale with the highest score in students of both sexes with a mean of 2,93 and a SD of 0,45 (p<0,001) indicating a high risk of disordered eating behaviours. Positive associations were found between risk of eating disorders and body weight (p=0,027), self-report of residence (p=0,013) in women (living without family) and with the non-omission of meals in men (p=0,010). In conclusion, high tendency to cognitive restriction and high prevalence of risk of suffering from eating disorders was found in nutrition students, especially those in the second year of studies and in women. Greater awareness and concern to prevent, detect and address eating disorders in nutrition students is needed, since eating disorders can not only affect physical and mental health, but also professional judgment of the students in the future. / Tesis
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La liste de mes jointures ; suivi de Habiter le corps : mise en scène du quotidien dans Lecture en vélocipède d’Huguette GaulinMénard, Évelyne 09 1900 (has links)
Mémoire en recherche-création / la liste de mes jointures récupère certaines paroles reçues, bruits parasitaires qui restent comme les acouphènes. Ils se déclenchent parfois à la suite d’un stress : les sifflements de la narratrice empirent au secondaire. Le trouble alimentaire aussi. Poésie du déséquilibre, la liste de mes jointures recense les chutes, les absences, les jugements, la jumelle qui nous échappe. Chaque section du recueil relie une partie du corps à une pièce de la maison. Et la peur de mourir à celle de vivre. Le regard des autres et de soi-même sont des miroirs impossibles à décrocher. L’alliance entre le corps et la maison se rencontre aussi dans Lecture en vélocipède d’Huguette Gaulin. Difficile à cerner, le quotidien apparaît aussi fragmenté que le sujet poétique : la maison est le lieu où tous deux se reconstruisent. Avec Habiter le corps : mise en scène du quotidien dans Lecture en vélocipède d’Huguette Gaulin, on a accès au dialogue entre l’intérieur et l’extérieur, au dédoublement du manque et à une maternité sans fin. / the list of my knuckles retrieves some words heard, paratic noises who stay like tinnitus. These are often triggered by anxiety : the narrator’s ringing gets worse in high school. The eating disorder too. Poetry of imbalance, the list of my knuckles inventories falls, absences, judgments, the twin sister who gets away from us. Each section of the book connects a part of the body to a room in the house. And a fear of dying to a fear of living. The gaze of others and of oneself are mirrors impossible to take down. Lecture en vélocipède of Huguette Gaulin also joins the body to the house. Everyday life is hard to define and appears as divided as the poetic subject : they both rebuild themselves in the house. Habiter le corps : mise en scène du quotidien dans Lecture en vélocipède d’Huguette Gaulin gives us access to the dialogue between the inside and the outside, the duplication of a lack and to an endless motherhood.
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