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Landolt SA, Weitkamp K, Roth M, Sisson NM, Bodenmann G. Dyadic coping and mental health in couples: A systematic review. Clin Psychol Rev 2023; 106:102344. [PMID: 37866090 DOI: 10.1016/j.cpr.2023.102344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 09/13/2023] [Accepted: 10/02/2023] [Indexed: 10/24/2023]
Abstract
Globally, one out of three people suffer from a mental health issue during their lifetime. In romantic relationships, impaired mental health does not only affect the individual but also their partner and therefore needs to be coped with dyadically. In this systematic review, we summarize research examining dyadic coping (DC) in the context of mental health and individual and relational outcomes. We searched for peer-reviewed articles published between January 1990 and April 2023 on PsycInfo, Medline, and PSYNDEX on DC and mental health within romantic relationships. A total of 60 qualitative, quantitative, and intervention studies met the inclusion criteria, reporting on 16,394 individuals and 4,945 dyads. To synthesize the studies, we used a narrative synthesis approach. Overall, stress expression and positive DC yielded beneficial individual and relational outcomes, whereas, for negative DC, the opposite was true. Results differed between mental health clusters and context played an important role (e.g., symptom severity, life phase). Due to the great diversity of studies and variables, further research should focus on understudied mental health clusters (e.g., anxiety disorders). Clinicians are advised to view mental health issues as a dyadic rather than an individual phenomenon ("we-disease") and develop tailored couple-centered interventions.
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Affiliation(s)
| | | | - Michelle Roth
- Department of Psychology, University of Zurich, Switzerland
| | - Natalie M Sisson
- Department of Psychology, University of Toronto Mississauga, Canada
| | - Guy Bodenmann
- Department of Psychology, University of Zurich, Switzerland
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2
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Tesselaar JM, Mendoza RR, Siegel JA, Elbe CI, Caravelli NS, DeJesus J, Fenton M, Victoria BS, Blashill AJ. A qualitative analysis of relationship advice from the perspective of people living with and recovering from eating disorders while in diverse romantic relationships. Eat Disord 2023; 31:632-650. [PMID: 37194296 DOI: 10.1080/10640266.2023.2206753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Eating disorders (EDs) have adverse consequences across life domains, ranging from physical health to interpersonal relationships. While research suggests that romantic partners have the potential to support ED recovery, partners to those with EDs often report feeling confused and helpless in the face of the condition. The extant literature on EDs in relationships centers on the experiences of cisgender, heterosexual women. The present study aimed to garner a more comprehensive understanding of the types of support people with EDs believe are most helpful from romantic partners by analyzing relationship advice from a diverse group of individuals with EDs who were in romantic relationships. As part of a larger study on romantic relationships in ED recovery, we analyzed responses to the question, "If you had to give one piece of advice to someone who learns that their partner has an ED, what would it be?" Through Consensual Qualitative Research-Modified, we identified 29 themes, which we grouped into 7 domains: Foster Open Communication, Create an Environment of Emotional Intimacy, Let Your Partner Guide You, Educate Yourself, Be Compassionate with Yourself, Use Caution when Discussing Food and Bodies, and a Miscellaneous domain. These findings highlight the importance of patience, flexibility, psychoeducation, and self-compassion for individuals working to support their partner's ED recovery, and can inform future couples-based treatments and interventions for EDs.
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Affiliation(s)
- Juliana M Tesselaar
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Rebecca R Mendoza
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Jaclyn A Siegel
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Connor I Elbe
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Nicolas S Caravelli
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Jennifer DeJesus
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Margo Fenton
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Brianna S Victoria
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Aaron J Blashill
- Department of Psychology, San Diego State University, San Diego, California, USA
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
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3
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Spivak-Lavi Z, Gewirtz-Meydan A. Why Do Women with Disordered Eating Engage in Sex? The Mediating Role of Sexual Motivations in the Association Between Disordered Eating Behaviors and Attitudes and Sexual Dysfunction. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:1513-1524. [PMID: 36376742 DOI: 10.1007/s10508-022-02463-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 10/12/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
Although there is growing evidence of an association between disordered eating and sexual dysfunction, the mechanism underlying this association is still unclear. In the current study, we sought to examine the mediating role of sexual motivation between disordered eating and sexual dysfunction. We used a multi-path mediation model to examine the mediating role of sexual motivation between disordered eating and sexual functioning among a sample of 341 non-clinical women in a steady relationship. Analysis revealed two significant mediation paths associating disordered eating with sexual functioning: (1) a high level of disordered eating was significantly linked with higher motivation for partner approval via sex and sexuality which, in turn, was associated with lower sexual functioning and (2) a high level of disordered eating was significantly linked with lower enhancement sexual motivation which, in turn, was associated with lower sexual functioning. This study extends the existing knowledge by offering an explanation for the relation between disordered eating and sexual dysfunction via sexual motives. Findings from the current study suggest women with disordered eating utilized sex for self-affirmation, for coping with negative emotions, for partner approval, and to increase intimacy. Also, these women were not likely to engage in sex for enhancement reasons.
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Affiliation(s)
- Zohar Spivak-Lavi
- Faculty of Social Work and Faculty of Education, Max Stern Yezreel Valley College, Emek Yezreel, Jezreel Valley, Israel
| | - Ateret Gewirtz-Meydan
- School of Social Work, University of Haifa, 199 Abba Khoushy Ave. Mount Carmel, 3498838, Haifa, Israel. Agewirtz-@univ.haifa.ac.il
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Johnson S, Gordon C, Myers B, Kantor R. "We can work it out": positive problem solving as a mediator between perspective-taking and relationship satisfaction among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:914-920. [PMID: 34242129 DOI: 10.1080/07448481.2021.1909044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Objective: The present study aimed to examine the role of positive problem solving in the relation between perspective taking and relationship satisfaction.Participants: One hundred and four college students participated in the present study, if they had been in a romantic relationship for a minimum of six months.Methods: Participants completed measures of relationship satisfaction, perspective-taking relative to romantic couples, and of positive problem-solving in couples.Results: As predicted, both perspective-taking and positive problem-solving were significantly related to relationship satisfaction. In addition, positive problem-solving emerged as a significant partial mediator of the relation between perspective-taking and relationship satisfaction.Conclusions: The benefits of skills training in the areas of perspective-taking and problem-solving in college student health and functioning are discussed.
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Affiliation(s)
- Sarah Johnson
- Department of Psychology, University of Tennessee, Knoxville, Tennessee, USA
| | - Cameron Gordon
- Psychology, Vancouver Island University, Nanaimo, British Columbia, Canada
| | - Bryan Myers
- Psychology, University of North Carolina Wilmington, Wilmington, North Carolina, USA
| | - Rachel Kantor
- Psychology, University of North Carolina Wilmington, Wilmington, North Carolina, USA
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5
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Batchelor R, Cribben H, Macdonald P, Treasure J, Cini E, Nicholls D, Kan C. The experiential perspectives of siblings and partners caring for a loved one with an eating disorder in the UK. BJPsych Open 2022; 8:e76. [PMID: 35322783 PMCID: PMC9059625 DOI: 10.1192/bjo.2022.43] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Caring for a loved one with an eating disorder typically comes with a multitude of challenges, yet siblings and partners are often overlooked. It is important to understand if current clinical guidance for supporting carers are effective and being utilised for these groups, to help meet their needs. AIMS To identify the experiential perspectives of siblings and partners of a loved one with an eating disorder compared with guidance for improving the adequacy of support provided to carers published by Beat and Academy for Eating Disorders. METHOD Three online focus groups were held for ten siblings and five partners from across the UK (12 females and three males). Carers had experience of caring for a loved one with anorexia nervosa (13 carers) or bulimia nervosa (two carers), across a range of therapeutic settings. Focus group transcriptions were analysed with thematic analysis. RESULTS Four key themes were identified: (a) role-specific needs, (b) challenges encountered by siblings and partners, (c) generic needs and helpful strategies or approaches, and (d) accounts of service provision and family support. CONCLUSIONS Overall, the majority of experiences reported by siblings and partners did not meet the published guidance. Consequently, clinical practice recommendations were identified for services, alongside the charity sector, to take a proactive approach in detecting difficulties, providing skills training and emotional/practical support, adapting/tailoring peer support groups and supporting online facilitation. Our findings part-informed the design of our national online survey on loved ones' experiences of care in eating disorders.
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Affiliation(s)
- Rachel Batchelor
- Department of Psychology, Royal Holloway, University of London, UK
| | - Hannah Cribben
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Pamela Macdonald
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Janet Treasure
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Erica Cini
- East London Eating Disorder Service for Children and Young People, East London NHS Foundation Trust, UK; and Nutrition Science Group, Division of Medicine, University College London, UK
| | | | - Carol Kan
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
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Spivak-Lavi Z, Gewirtz-Meydan A. Eating Disorders and Sexual Satisfaction: The Mediating Role of Body Image Self-consciousness during Physical Intimacy and Dissociation. JOURNAL OF SEX RESEARCH 2022; 59:344-353. [PMID: 34269636 DOI: 10.1080/00224499.2021.1948491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Women with eating disorders experience difficulties related to sexual activity, yet little is known about the indirect association between eating disorders and sexual satisfaction. This study examined the indirect association between eating disorders and sexual satisfaction using body image self-consciousness during physical intimacy and dissociation as mediators. Online questionnaires were answered by 985 Israeli women. Of them, 98 were identified as likely to have eating disorders (study group). A matching control group (n = 98) was selected from the remaining respondents. Participants in the study group had significantly higher body image self-consciousness and dissociation than the matched controls, as well as significantly lower sexual satisfaction. The research model revealed that body image self-consciousness during physical intimacy mediates the link between eating disorders and sexual satisfaction, while dissociation does not. Women with eating disorders have higher levels of self-consciousness about their body during sexual activity, which may distract them from their own sexual needs and desires and those of their partners, and this, in turn, is associated with sexual dissatisfaction. Findings highlight the need for improved evidenced-based assessment and management of the sexual satisfaction of women with eating disorders.Abbreviations: ED: eating disorders; AN: anorexia nervosa; BN: bulimia nervosa; BED: binge eating disorder.
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Affiliation(s)
- Zohar Spivak-Lavi
- Faculty of Social Work & Faculty of Education, Max Stern Yezreel Valley College
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Baer NR, Zoellick JC, Deutschbein J, Anton V, Bergmann MM, Schenk L. Dietary preferences in the context of intra-couple dynamics: Relationship types within the German NutriAct family cohort. Appetite 2021; 167:105625. [PMID: 34364966 DOI: 10.1016/j.appet.2021.105625] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 07/30/2021] [Accepted: 08/02/2021] [Indexed: 11/17/2022]
Abstract
To promote healthy diets in older age, a comprehensive understanding of factors influencing dietary behaviour and underlying preferences is essential. Romantic relationships are focal socialisation contexts, in which diet-related preferences and practices are dynamically negotiated. Our aim was to reconstruct intra-couple dynamics shaping dietary preferences and comparatively analyse relationship types among older couples. Data basis was the NutriAct Family Study - a German web-based cohort. Analyses were based on three a priori defined relationship types: 1) both partners' mutual adaptation of dietary preferences (symmetrical convergence), 2) unilateral adaptation (asymmetrical convergence) and 3) persistence of individual preferences. Relationship types were, among others, comparatively analysed using ANOVAs. Intra-couple dynamics within the asymmetrical convergence type were measured by multivariate logistic regression. The dyadic sample consisted of 398 couples resp. N = 796 individuals aged 63.99 years (SD = 6.15). All three relationship types were identified (symmetrical convergence: n = 62, 15.6 %; asymmetrical convergence: n = 199, 50.0 %; persistence: n = 137, 34.4 %). Within the asymmetrical convergence type, women were more likely to take a dominant role compared to their male partners (OR: 24.40; 95%CI: 14.37-41.41). This study demonstrates the fundamental influence of intra-couple dynamics on individual dietary preferences, whereby traditional gender roles have shown to play a central moderating role. Our study findings are relevant for the development and implementation of public health (nutrition) strategies, since they highlight the importance of understanding dietary preferences as jointly constructed and shaped in the intra-couple context, rather than as isolated, individually developed ones. In this context, future research directions and practical implications targeting not only individuals but involving couples are discussed.
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Affiliation(s)
- Nadja-Raphaela Baer
- Institute of Medical Sociology and Rehabilitation Research, Charité - University Medicine Berlin, Charitéplatz 1, 10117, Berlin, Germany.
| | - Jan C Zoellick
- Institute of Medical Sociology and Rehabilitation Research, Charité - University Medicine Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Johannes Deutschbein
- Institute of Medical Sociology and Rehabilitation Research, Charité - University Medicine Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Verena Anton
- Institute of Medical Sociology and Rehabilitation Research, Charité - University Medicine Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Manuela M Bergmann
- German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany
| | - Liane Schenk
- Institute of Medical Sociology and Rehabilitation Research, Charité - University Medicine Berlin, Charitéplatz 1, 10117, Berlin, Germany
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8
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Reyes-Rodríguez ML, Watson HJ, Smith TW, Baucom DH, Bulik CM. Promoviendo una Alimentación Saludable (PAS) results: Engaging Latino families in eating disorder treatment. Eat Behav 2021; 42:101534. [PMID: 34217036 PMCID: PMC8380698 DOI: 10.1016/j.eatbeh.2021.101534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 06/05/2021] [Accepted: 06/17/2021] [Indexed: 12/23/2022]
Abstract
Latinos/as are underrepresented in eating disorders clinical trials. This study compared results of a culturally adapted individual cognitive-behavioral treatment (CBT) for binge-spectrum eating disorders that included or excluded a family enhanced module (CBT + FE), in a proof-of-principle pilot study with a sample of Latina adults and one family member per patient. Twenty-five patients (Mage = 37 yrs) and 25 family members (Mage = 40 yrs) were randomized to CBT (n = 13) or CBT+ FE (n = 12). DSM-IV eating disorder diagnoses were: 48% (n = 12) bulimia nervosa, 28% (n = 7) binge-eating disorder, and 24% (n = 6) eating disorder not otherwise specified. Effect sizes favored CBT + FE on adherence and retention, and scores on treatment satisfaction and therapeutic alliance were high, indicating treatment acceptability. In spite of the hypothesis that family outcomes such as support, familism, cohesion, pride, family cultural conflict, burden, and marital satisfaction (in couples) would be superior in CBT + FE, the preliminary data were inconclusive and results were mixed. The hypothesis that eating disorder outcomes including global eating psychopathology, binge eating, and purging would improve in CBT + FE was not supported. There was some evidence that patients in CBT improved more particularly on binge eating, otherwise the groups had no differences. In conclusion, the results suggest that CBT + FE could enhance treatment adherence and retention, although this did not automatically translate to better family and symptom outcomes.
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Affiliation(s)
- Mae Lynn Reyes-Rodríguez
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States of America.
| | - Hunna J. Watson
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC,Division of Paediatrics, The University of Western Australia, Perth, Australia,School of Psychology, Curtin University, Perth, Australia
| | - Tosha Woods Smith
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC
| | - Donald H. Baucom
- Department of Psychology, University of North Carolina, Chapel Hill, NC
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC,Department of Nutrition, University of North Carolina, Chapel Hill, NC,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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9
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Gewirtz-Meydan A, Spivak-Lavi Z. Profiles of Sexual Disorders and Eating Disorder Symptoms: Associations With Body Image. J Sex Med 2021; 18:1364-1373. [PMID: 37057460 DOI: 10.1016/j.jsxm.2021.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 05/28/2021] [Accepted: 06/11/2021] [Indexed: 01/23/2023]
Abstract
BACKGROUND Although the empirical evidence supporting the co-occurrence of sexual disorders and eating disorders is growing, it is not yet known how often these 2 conditions co-occur, and whether the comorbidities of sexual disorders and eating disorders differ in any specific ways. AIM To examine the co-occurrence of sexual disorders and eating disorders. METHODS In the current study, we used latent profile analysis to identify distinct profiles of sexual disorders and eating disorder symptoms among a large non-clinical sample of women (n = 985). We also examined how these profiles differed in terms of body image self-consciousness. The study was conducted as an online survey among a convenience sample of Israeli women. MAIN OUTCOME MEASURES For sexual disorders we used the Arizona Sexual Experience Scale, and for eating disorders we used the Eating Disorders Inventory 2. RESULTS Latent profile analysis revealed 4 profiles: no disorder (low levels of sexual disorders and eating disorder symptoms), eating disorder symptoms (low levels of sexual disorders and high levels of eating disorder symptoms), sexual disorders (high levels of sexual disorders and low levels of eating disorder symptoms), and comorbidity (high levels of both sexual disorders and eating disorder symptoms). Women in the comorbidity group had significantly more body image self-consciousness during sexual activity than did women in the other groups. CONCLUSION The 4 profiles identified in the study support the co-occurrence of sexual disorders and eating disorder symptoms, yet also raise many clinical considerations. Limitations of the study, directions for future research, and clinical implications are discussed. Gewirtz-Meydan A, Spivak-Lavi Z. Profiles of Sexual Disorders and Eating Disorder Symptoms: Associations With Body Image. J Sex Med 2021;18:1364-1373.
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Affiliation(s)
- Ateret Gewirtz-Meydan
- School of Social Work, University of Haifa, Haifa, Israel. Agewirtz-@univ.haifa.ac.il
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Christensen KA, Haynos AF. A theoretical review of interpersonal emotion regulation in eating disorders: enhancing knowledge by bridging interpersonal and affective dysfunction. J Eat Disord 2020; 8:21. [PMID: 32514350 PMCID: PMC7262763 DOI: 10.1186/s40337-020-00298-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 04/23/2020] [Indexed: 01/10/2023] Open
Abstract
Individuals with eating disorders (EDs) frequently report interpersonal and affective dysfunction. A useful lens for uniting these ideas is through the framework of interpersonal emotion regulation (IER), which consists of the ways others assist a distressed individual and how this shapes his or her subsequent emotional, behavioral, and cognitive responses. In this theoretical review, we provide an overview of the rationale for exploring IER and review IER processes in this population using the framework of the Process Model of Emotion Regulation. Finally, we offer suggestions for next steps in conducting research. IER offers a parsimonious way to explore social and emotional constructs related to ED pathology and may provide potential targets for prevention and intervention in these difficult-to-treat disorders.
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Affiliation(s)
- Kara A. Christensen
- Department of Psychology, University of Kansas, 1415 Jayhawk Blvd Rm 440, Lawrence, KS 66045 USA
| | - Ann F. Haynos
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, 2450 Riverside Ave, F253, Minneapolis, MN 55454 USA
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11
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Birmingham WC, Cavallini AQ, Sgro J. Spousal influence: A study of women with eating and body image concerns. J Health Psychol 2019; 26:1339-1352. [PMID: 31495225 DOI: 10.1177/1359105319873946] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Eating disorder literature often overlooks those exhibiting eating and body image concerns without an eating disorder diagnosis. Supportive spouses may ameliorate negative body image and eating behavior, but spouses who exhibit both supportive and non-supportive behaviors concurrently (ambivalent) may send mixed messages. Eating disorder behaviors and spousal interactions were assessed in 61 women who demonstrated eating disordered behavior and body dissatisfaction but were not clinically diagnosed with an eating disorder. Spouses mostly provided messages of reassurance. However, some women were unable to overcome their internalized negative body image. Feelings of social comparison were seen with ambivalent spouses. Supportive relationships may be protective, but actual interventions may be needed to change negative body image.
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12
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Reyes-Rodríguez ML, Watson HJ, Barrio C, Baucom DH, Silva Y, Luna-Reyes KL, Bulik CM. Family involvement in eating disorder treatment among Latinas. Eat Disord 2019; 27:205-229. [PMID: 31084429 PMCID: PMC6542266 DOI: 10.1080/10640266.2019.1586219] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Latinos are less likely to seek health care for eating disorders and more likely to drop out of treatment than members of other ethnic groups, highlighting existing challenges to engagement in traditional mental health care. This study explored the role of family in the treatment of adult Latinas with eating disorders through content analysis of family sessions adjunctive to cognitive behavioral therapy. This study yielded insight into the experiences of 10 Latinas with eating disorders (M age = 39.90 years) and 10 relatives (M age = 39.50) from the Promoviendo una Alimentación Saludable trial who were randomly selected to receive six family enhancement sessions. Data from 53 sessions were analyzed using a qualitative content analysis approach. Family intervention might serve as a valuable adjunct to conventional treatment by positively influencing social, family, and emotional support for Latinas with eating disorders.
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Affiliation(s)
| | - Hunna J Watson
- a Department of Psychiatry , University of North Carolina , Chapel Hill , NC , USA.,b School of Paediatrics and Child Health , University of Western Australia , Perth , Australia.,c School of Psychology and Speech Pathology , Curtin University , Perth , Australia
| | - Concepción Barrio
- d Suzanne Dworak-Peck School of Social Work , University of Southern California , Los Angeles , CA , USA
| | - Donald H Baucom
- e Department of Psychology , University of North Carolina , Chapel Hill , NC , USA
| | - Yormeri Silva
- a Department of Psychiatry , University of North Carolina , Chapel Hill , NC , USA
| | - Kiara L Luna-Reyes
- f Department of Psychology , University of North Carolina , Greensboro , NC , USA
| | - Cynthia M Bulik
- a Department of Psychiatry , University of North Carolina , Chapel Hill , NC , USA.,g Department of Nutrition , University of North Carolina , Chapel Hill , NC , USA.,h Department of Medical Epidemiology and Biostatistics , Karolinska Institutet , Stockholm , NC , Sweden
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13
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Abstract
Systemic Treatment of Eating Disorders Abstract. Eating disorders (EDs) are deleterious illnesses that are associated with significant psychiatric and medical morbidity and mortality, considerable distress and impairment, marked caregiver burden, and high treatment costs. Because EDs commonly onset in adolescence and young adulthood, and with consistent evidence that early intervention results in the most promising treatment outcomes, an increasing amount of research has been devoted to the treatment of adolescent EDs. Although still less researched in adult presentations of EDs, the historical record of research on adolescent ED treatment over the last half-century principally supports family therapy. Current published clinical guidelines recommend an ED-specific family therapy as the first-line treatment of adolescents with anorexia nervosa (AN) and as a recommended treatment of adolescents with bulimia nervosa (BN). The number of treatment trials for adolescent AN has slowly grown over the last few decades and, more recently, family interventions include protocols extending to new populations and diagnoses, including BN. This narrative review summarizes existing family-based approaches to the treatment of adolescent EDs, integrating recent research findings. This article also includes discussion of methods, both current and proposed, that expand and adapt current family-based approaches in efforts to improve the breadth and scope of ED treatment in adolescence and young adulthood.
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Affiliation(s)
- Patrick Pasi
- Klinik für Konsiliarpsychiatrie und Psychosomatik, Universitätsspital Zürich
| | - Dagmar Pauli
- Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie, PUK Zürich
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14
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Hilbert A, Bodenmann G. Kognitive Verhaltenstherapie für Paare: Fallstudie einer doppelten Binge-Eating-Störung. PSYCHOTHERAPEUT 2018. [DOI: 10.1007/s00278-018-0309-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Runfola CD, Kirby JS, Baucom DH, Fischer MS, Baucom BRW, Matherne CE, Pentel KZ, Bulik CM. A pilot open trial of UNITE-BED: A couple-based intervention for binge-eating disorder. Int J Eat Disord 2018; 51:1107-1112. [PMID: 30189106 DOI: 10.1002/eat.22919] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 06/06/2018] [Accepted: 06/06/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To evaluate the feasibility, acceptability, and preliminary efficacy of a couple-based intervention for binge-eating disorder (BED), called UNiting couples In the Treatment of Eating disorders-BED edition (UNITE-BED). METHOD In an open pilot trial, 11 couples in which one or both adult partners had a diagnosis of DSM-5 threshold or sub-threshold BED participated in 22 weekly sessions of UNITE-BED. Patients also received individual treatment, outside of the context of the trial. Couples completed measures on treatment satisfaction, eating disorder symptom severity, depression, anxiety, emotion regulation, and relational functioning at post-treatment and 3-month follow-up. Statistical analyses were conducted to identify change over the course of treatment. RESULTS UNITE was feasible and acceptable to the majority of couples (9% dropout; high satisfaction ratings). Objective binge abstinence was 81.8% and subjective binge abstinence was 45.5% by post-treatment. Patient binge-eating symptomatology reduced over the course of treatment with results maintained at follow up. Patients' depression symptoms decreased and patients' emotion regulation improved at both time points. DISCUSSION Including partners in treatment for BED may be beneficial. Results support further evaluation of the efficacy of couple-based interventions for BED in larger randomized-controlled trials.
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Affiliation(s)
- Cristin D Runfola
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.,Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, US
| | - Jennifer S Kirby
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, US
| | - Donald H Baucom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, US
| | - Melanie S Fischer
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, US
| | - Brian R W Baucom
- Department of Psychology, University of Utah, Salt Lake City, Utah
| | - Camden E Matherne
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, US
| | - Kimberly Z Pentel
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, US
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, US.,Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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16
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Schaumberg K, Welch E, Breithaupt L, Hübel C, Baker JH, Munn-Chernoff MA, Yilmaz Z, Ehrlich S, Mustelin L, Ghaderi A, Hardaway AJ, Bulik-Sullivan EC, Hedman AM, Jangmo A, Nilsson IAK, Wiklund C, Yao S, Seidel M, Bulik CM. The Science Behind the Academy for Eating Disorders' Nine Truths About Eating Disorders. EUROPEAN EATING DISORDERS REVIEW 2017; 25:432-450. [PMID: 28967161 PMCID: PMC5711426 DOI: 10.1002/erv.2553] [Citation(s) in RCA: 126] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 08/16/2017] [Accepted: 08/18/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE In 2015, the Academy for Eating Disorders collaborated with international patient, advocacy, and parent organizations to craft the 'Nine Truths About Eating Disorders'. This document has been translated into over 30 languages and has been distributed globally to replace outdated and erroneous stereotypes about eating disorders with factual information. In this paper, we review the state of the science supporting the 'Nine Truths'. METHODS The literature supporting each of the 'Nine Truths' was reviewed, summarized and richly annotated. RESULTS Most of the 'Nine Truths' arise from well-established foundations in the scientific literature. Additional evidence is required to further substantiate some of the assertions in the document. Future investigations are needed in all areas to deepen our understanding of eating disorders, their causes and their treatments. CONCLUSIONS The 'Nine Truths About Eating Disorders' is a guiding document to accelerate global dissemination of accurate and evidence-informed information about eating disorders. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Katherine Schaumberg
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Elisabeth Welch
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Lauren Breithaupt
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychology, George Mason University, Fairfax, VA, USA
| | - Christopher Hübel
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Jessica H Baker
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Zeynep Yilmaz
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Linda Mustelin
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Public Health and Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
| | - Ata Ghaderi
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Andrew J Hardaway
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Emily C Bulik-Sullivan
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Anna M Hedman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Andreas Jangmo
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Ida A K Nilsson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska Hospital, Stockholm, Sweden
| | - Camilla Wiklund
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Shuyang Yao
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Maria Seidel
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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17
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Fischer MS, Baucom DH, Cohen MJ. Cognitive-Behavioral Couple Therapies: Review of the Evidence for the Treatment of Relationship Distress, Psychopathology, and Chronic Health Conditions. FAMILY PROCESS 2016; 55:423-42. [PMID: 27226429 DOI: 10.1111/famp.12227] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Cognitive-behavioral couple therapy (CBCT) is an approach to assisting couples that has strong empirical support for alleviating relationship distress. This paper provides a review of the empirical status of CBCT along with behavioral couple therapy (BCT), as well as the evidence for recent applications of CBCT principles to couple-based interventions for individual psychopathology and medical conditions. Several meta-analyses and major reviews have confirmed the efficacy of BCT and CBCT across trials in the United States, Europe, and Australia, and there is little evidence to support differential effectiveness of various forms of couple therapy derived from behavioral principles. A much smaller number of effectiveness studies have shown that successful implementation in community settings is possible, although effect sizes tend to be somewhat lower than those evidenced in randomized controlled trials. Adapted for individual problems, cognitive-behavioral couple-based interventions appear to be at least as effective as individual cognitive behavioral therapy (CBT) across a variety of psychological disorders, and often more effective, especially when partners are substantially involved in treatment. In addition, couple-based interventions tend to have the unique added benefit of improving relationship functioning. Findings on couple-based interventions for medical conditions are more varied and more complex to interpret given the greater range of target outcomes (psychological, relational, and medical variables).
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Affiliation(s)
- Melanie S Fischer
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC.
| | - Donald H Baucom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Matthew J Cohen
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC
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