1
|
Bond KA, Williams E, Nicholson S, Lim S, Johnson D, Cox B, Putland M, Gardiner E, Tippett E, Graham M, Mordant F, Catton M, Lewin SR, Subbarao K, Howden BP, Williamson DA. Longitudinal evaluation of laboratory-based serological assays for SARS-CoV-2 antibody detection. Pathology 2021; 53:773-779. [PMID: 34412859 PMCID: PMC8289701 DOI: 10.1016/j.pathol.2021.05.093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/02/2021] [Accepted: 05/17/2021] [Indexed: 01/03/2023]
Abstract
Serological assays for SARS-CoV-2 infection are now widely available for use in diagnostic laboratories. Limited data are available on the performance characteristics in different settings, and at time periods remote from the initial infection. Validation of the Abbott (Architect SARS-CoV-2 IgG), DiaSorin (Liaison SARS-CoV-2 S1/S2 IgG) and Roche (Cobas Elecsys Anti-SARS-CoV-2) assays was undertaken utilising 217 serum samples from 131 participants up to 7 months following COVID-19 infection. The Abbott and DiaSorin assays were implemented into routine laboratory workflow, with outcomes reported for 2764 clinical specimens. Sensitivity and specificity were concordant with the range reported by the manufacturers for all assays. Sensitivity across the convalescent period was highest for the Roche at 95.2-100% (95% CI 81.0-100%), then the DiaSorin at 88.1-100% (95% CI 76.0-100%), followed by the Abbott 68.2-100% (95% CI 53.4-100%). Sensitivity of the Abbott assay fell from approximately 5 months; on this assay paired serum samples for 45 participants showed a significant drop in the signal-to-cut-off ratio and 10 sero-reversion events. When used in clinical practice, all samples testing positive by both DiaSorin and Abbott assays were confirmed as true positive results. In this low prevalence setting, despite high laboratory specificity, the positive predictive value of a single positive assay was low. Comprehensive validation of serological assays is necessary to determine the optimal assay for each diagnostic setting. In this low prevalence setting we found implementation of two assays with different antibody targets maximised sensitivity and specificity, with confirmatory testing necessary for any sample which was positive in only one assay.
Collapse
Affiliation(s)
- K A Bond
- Department of Microbiology, Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia; Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia.
| | - E Williams
- Department of Microbiology, Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
| | - S Nicholson
- Victorian Infectious Diseases Reference Laboratory at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
| | - S Lim
- Department of General Medicine and Infectious Diseases, Royal Melbourne Hospital, Melbourne, Vic, Australia; Department of General Medicine, The University of Melbourne, Vic, Australia
| | - D Johnson
- Department of General Medicine and Infectious Diseases, Royal Melbourne Hospital, Melbourne, Vic, Australia; Department of General Medicine, The University of Melbourne, Vic, Australia
| | - B Cox
- Department of Microbiology, Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia; Department of General Medicine and Infectious Diseases, Royal Melbourne Hospital, Melbourne, Vic, Australia
| | - M Putland
- Department of Emergency Medicine, Royal Melbourne Hospital, Melbourne, Vic, Australia
| | - E Gardiner
- Department of Emergency Medicine, Royal Melbourne Hospital, Melbourne, Vic, Australia
| | - E Tippett
- Department of Microbiology, Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia; Department of General Medicine and Infectious Diseases, Royal Melbourne Hospital, Melbourne, Vic, Australia
| | - M Graham
- Department of Microbiology and Infectious Diseases, Monash Health, Vic, Australia; The Peter Doherty Institute for Infection and Immunity, Royal Melbourne Hospital and The University of Melbourne, Melbourne, Vic, Australia
| | - F Mordant
- WHO Collaborating Centre for Reference and Research on Influenza at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
| | - M Catton
- Victorian Infectious Diseases Reference Laboratory at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
| | - S R Lewin
- The Peter Doherty Institute for Infection and Immunity, Royal Melbourne Hospital and The University of Melbourne, Melbourne, Vic, Australia; Department of Infectious Diseases, Alfred Hospital and Monash University, Melbourne, Vic, Australia
| | - K Subbarao
- Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia; WHO Collaborating Centre for Reference and Research on Influenza at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
| | - B P Howden
- Department of Microbiology, Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia; Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia; The Peter Doherty Institute for Infection and Immunity, Royal Melbourne Hospital and The University of Melbourne, Melbourne, Vic, Australia; Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
| | - D A Williamson
- Department of Microbiology, Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia; Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia; The Peter Doherty Institute for Infection and Immunity, Royal Melbourne Hospital and The University of Melbourne, Melbourne, Vic, Australia; Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
| |
Collapse
|
2
|
Dunstan SJ, Williamson DA, Denholm JT. Understanding the global tuberculosis epidemic: moving towards routine whole-genome sequencing. Int J Tuberc Lung Dis 2019; 23:1241-1242. [PMID: 31931906 DOI: 10.5588/ijtld.19.0604] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- S J Dunstan
- Doherty Department, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne
| | - D A Williamson
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Microbiological Diagnostic Unit Public Health Laboratory, Peter Doherty Institute for Infection and Immunity, Melbourne
| | - J T Denholm
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victorian Tuberculosis Programme, Melbourne Health, Melbourne, VIC, Australia
| |
Collapse
|
3
|
Raynes JM, Young PG, Proft T, Williamson DA, Baker EN, Moreland NJ. Protein adhesins as vaccine antigens for Group A Streptococcus. Pathog Dis 2018; 76:4919728. [DOI: 10.1093/femspd/fty016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 03/01/2018] [Indexed: 12/20/2022] Open
Affiliation(s)
- J M Raynes
- School of Medical Sciences, The University of Auckland, 85 Park Road, Auckland 1023, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, 3A Symonds Street, Auckland 1010, New Zealand
| | - P G Young
- Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, 3A Symonds Street, Auckland 1010, New Zealand
- School of Biological Sciences, University of Auckland, 5 Symonds Street, Auckland 1010, New Zealand
| | - T Proft
- School of Medical Sciences, The University of Auckland, 85 Park Road, Auckland 1023, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, 3A Symonds Street, Auckland 1010, New Zealand
| | - D A Williamson
- Microbiological Diagnostic Unit Public Health Laboratory, Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria 3000, Australia
| | - E N Baker
- Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, 3A Symonds Street, Auckland 1010, New Zealand
- School of Biological Sciences, University of Auckland, 5 Symonds Street, Auckland 1010, New Zealand
| | - N J Moreland
- School of Medical Sciences, The University of Auckland, 85 Park Road, Auckland 1023, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, 3A Symonds Street, Auckland 1010, New Zealand
| |
Collapse
|
4
|
Ong JJ, Fethers K, Howden BP, Fairley CK, Chow EPF, Williamson DA, Petalotis I, Aung E, Kanhutu K, De Petra V, Chen MY. Asymptomatic and symptomatic urethral gonorrhoea in men who have sex with men attending a sexual health service. Clin Microbiol Infect 2017; 23:555-559. [PMID: 28257898 DOI: 10.1016/j.cmi.2017.02.020] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 02/16/2017] [Accepted: 02/18/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Guidelines regarding whether men who have sex with men (MSM) without symptoms of urethritis should be screened for urethral gonorrhoea differ between countries. We examined the rate of asymptomatic urethral gonorrhoea in MSM using sensitive nucleic acid amplification testing. METHODS This study was conducted on consecutive MSM attending the Melbourne Sexual Health Centre between July 2015 and May 2016 for sexually transmitted infections screening. Gonorrhoea testing with the Aptima Combo 2 (AC2) assay was performed on all urine specimens obtained from MSM, whether symptoms of urethritis were present or not. Men were classified as having: typical discharge if they reported symptoms suggesting purulent discharge; other symptoms if they reported other symptoms of urethritis; and no symptoms if they reported no urethral symptoms. RESULTS During the study period, there were 7941 clinic visits by 5947 individual MSM with 7090 urine specimens obtained from 5497 individual MSM tested with the AC2 assay. Urethral gonorrhoea was detected in 242 urine specimens from 228 individual MSM. The majority (189/242, 78%, 95% CI 73-83) reported typical discharge, 27/242 (11%, 95% CI 8-16) reported other urethral symptoms, and 26/242 (11%, 95% CI 7-15) reported no symptoms on the day of presentation and testing. Among men with urethral gonorrhoea, the proportions with concurrent pharyngeal or rectal gonorrhoea were 32% (134/210) and 64% (74/235), respectively. The mean interval between last reported sexual contact and onset of typical urethral discharge, where present, was 3.9 days. CONCLUSION The findings from our study lend support to guidelines that recommend screening asymptomatic MSM for urethral gonorrhoea.
Collapse
Affiliation(s)
- J J Ong
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia.
| | - K Fethers
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia
| | - B P Howden
- Microbiological Diagnostic Unit, Department of Microbiology and Immunology at the Peter Doherty Institution for Infection and Immunity, University of Melbourne, Melbourne, Vic., Australia
| | - C K Fairley
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia
| | - E P F Chow
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia
| | - D A Williamson
- Microbiological Diagnostic Unit, Department of Microbiology and Immunology at the Peter Doherty Institution for Infection and Immunity, University of Melbourne, Melbourne, Vic., Australia
| | - I Petalotis
- Microbiological Diagnostic Unit, Department of Microbiology and Immunology at the Peter Doherty Institution for Infection and Immunity, University of Melbourne, Melbourne, Vic., Australia
| | - E Aung
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia
| | - K Kanhutu
- University of Melbourne, Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Vic., Australia
| | - V De Petra
- Microbiological Diagnostic Unit, Department of Microbiology and Immunology at the Peter Doherty Institution for Infection and Immunity, University of Melbourne, Melbourne, Vic., Australia
| | - M Y Chen
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia.
| |
Collapse
|
5
|
Ip EH, Zhang Q, Schwartz R, Tooze J, Leng X, Han H, Williamson DA. Multi-profile hidden Markov model for mood, dietary intake, and physical activity in an intervention study of childhood obesity. Stat Med 2013; 32:3314-31. [PMID: 23322318 PMCID: PMC3710544 DOI: 10.1002/sim.5719] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Revised: 11/23/2012] [Accepted: 12/03/2012] [Indexed: 11/08/2022]
Abstract
Motivated by an application to childhood obesity data in a clinical trial, this paper describes a multi-profile hidden Markov model (HMM) that uses several temporal chains of measures respectively related to psychosocial attributes, dietary intake, and energy expenditure behaviors of adolescents in a school setting. Using these psychological and behavioral profiles, the model delineates health states from the longitudinal data set. Furthermore, a two-level regression model that takes into account the clustering effects of students within school is used to assess the effects of school-based and community-based interventions and other risk factors on the transition between health states over time. The results from our study suggest that female students tend to decrease their physical activities despite a high level of anxiety about weight. The finding is consistent across intervention and control arms.
Collapse
Affiliation(s)
- E H Ip
- Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston Salem, NC 27157, USA.
| | | | | | | | | | | | | |
Collapse
|
6
|
Williamson DA, Freeman JT, Roberts SA, Heffernan H, Dyet K, Paterson DL, Rogers BA, Sidjabat HE, Masters J. Rectal colonization with New Delhi metallo- -lactamase-1-producing Escherichia coli prior to transrectal ultrasound (TRUS)-guided prostate biopsy. J Antimicrob Chemother 2013; 68:2957-9. [DOI: 10.1093/jac/dkt266] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
|
7
|
Williamson DA, Barrett LK, Rogers BA, Freeman JT, Hadway P, Paterson DL. Infectious Complications Following Transrectal Ultrasound-Guided Prostate Biopsy: New Challenges in the Era of Multidrug-Resistant Escherichia coli. Clin Infect Dis 2013; 57:267-74. [DOI: 10.1093/cid/cit193] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
|
8
|
Anton SD, Gallagher J, Carey VJ, Laranjo N, Cheng J, Champagne CM, Ryan DH, McManus K, Loria CM, Bray GA, Sacks FM, Williamson DA. Diet type and changes in food cravings following weight loss: findings from the POUNDS LOST Trial. Eat Weight Disord 2012; 17:e101-8. [PMID: 23010779 PMCID: PMC4189179 DOI: 10.1007/bf03325333] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Few well-controlled trials have evaluated the effects that macronutrient composition has on changes in food cravings during weight loss treatment. The present study, which was part of the Preventing Overweight Using Novel Dietary Strategies (POUNDS LOST) trial, investigated whether the fat and protein content of four different diets affected changes in specific food cravings in overweight and obese adults. A sample of 811 adults were recruited across two clinical sites, and each participant was randomly assigned to one of four macronutrient prescriptions: 1) low fat (20% of energy), average protein (15% of energy); 2) moderate fat (40%), average protein (15%); 3) low fat (20%), high protein (25%); 4) moderate fat (40%), high protein (25%). With few exceptions, the type of diet that participants were assigned did not differentially affect changes in specific food cravings. Participants assigned to the high-fat diets, however, had reduced cravings for carbohydrates at month 12 (p<0.05) and fruits and vegetables at month 24. Also, participants assigned to high-protein diets had increased cravings for sweets at month 6 and month 12 (ps<0.05). Participants in all four dietary conditions reported significant reductions in food cravings for specific types of foods (i.e., high fat foods, fast food fats, sweets, and carbohydrates/starches; all ps<0.05). Cravings for fruits and vegetables, however, were increased at month 24 (p<0.05). Calorically restricted diets (regardless of their macronutrient composition) yielded significant reductions in cravings for fats, sweets, and starches whereas cravings for fruits and vegetables were increased.
Collapse
Affiliation(s)
- S D Anton
- Pennington Biomedical Research Center, LSU System, Baton Rouge, LA, USA.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Williamson DA, Roberts SA, Bower JE, Vaughan R, Newton S, Lowe O, Lewis CA, Freeman JT. Clinical failures associated with rpoB mutations in phenotypically occult multidrug-resistant Mycobacterium tuberculosis. Int J Tuberc Lung Dis 2012; 16:216-20. [DOI: 10.5588/ijtld.11.0178] [Citation(s) in RCA: 89] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- D. A. Williamson
- Department of Clinical Microbiology, Auckland City Hospital, Auckland, New Zealand
| | - S. A. Roberts
- Department of Clinical Microbiology, Auckland City Hospital, Auckland, New Zealand
| | - J. E. Bower
- Department of Clinical Microbiology, Auckland City Hospital, Auckland, New Zealand
| | - R. Vaughan
- Department of Clinical Microbiology, Auckland City Hospital, Auckland, New Zealand
| | - S. Newton
- Department of Clinical Microbiology, Auckland City Hospital, Auckland, New Zealand
| | - O. Lowe
- Department of Clinical Microbiology, Auckland City Hospital, Auckland, New Zealand
| | - C. A. Lewis
- Department of Respiratory Medicine, Auckland City Hospital, Auckland, New Zealand
| | - J. T. Freeman
- Department of Clinical Microbiology, Auckland City Hospital, Auckland, New Zealand
| |
Collapse
|
10
|
Mitchell SJ, Hilmer SN, Kirkpatrick CMJ, Hansen RD, Williamson DA, Singh NA, Finnegan TP, Allen BJ, Diamond TH, Diwan AD, Lloyd BD, Smith EUR, Fiatarone Singh MA. Estimation of lean body weight in older women with hip fracture. J Nutr Health Aging 2012; 16:188-92. [PMID: 22323357 DOI: 10.1007/s12603-011-0100-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Lean body weight (LBW) decreases with age while total body fat increases, resulting in altered drug pharmacokinetics. A semi-mechanistic equation estimating LBW using height, weight and sex has been developed for potential use across a wide range of body compositions. The aim of this study was to determine the ability of the LBW equation to estimate dual energy x-ray absorptiometry-derived fat free mass (FFM(DXA)) in a population of older women with recent hip fracture. METHODS Baseline, four and 12 month data obtained from 23 women enrolled in the Sarcopenia and Hip Fracture study were pooled to give 58 measurements. LBW was estimated using the equation: LBW (kg) = (9270 x Wt) / (8780 + (244 x BMI)). Body composition was classified as: 'normal' (BMI <25kg/m(2) and not sarcopenic), 'overweight-obese' (BMI >25kg/m(2) and not sarcopenic), 'sarcopenic' (sarcopenic and BMI <25kg/m(2)), or 'sarcopenic-obese' (sarcopenic and BMI >25kg/m(2)). The ability of the LBW equation to predict FFMDXA was determined graphically using Bland-Altman plots and quantitatively using the method of Sheiner and Beal. RESULTS The mean ± SD age of female participants women was 83±7 years (n=23). Sarcopenia was frequently observed (65.2%). Bland-Altman plots demonstrated an underestimation by the LBW equation compared to FFMDXA. The bias (95% CI) and precision (95% CI) calculated using the method of Sheiner and Beal was 0.5kg (-0.7, 1.66kg) and 4.4kg (-3.7, 12.4kg) respectively for pooled data. CONCLUSION This equation can be used to easily calculate LBW. When compared to FFMDXA, the LBW equation resulted in a small underestimation on average in this population of women with recent hip fracture. The degree of bias may not be clinically important although further studies of larger heterogeneous cohorts are needed to investigate and potentially improve the accuracy of this predictive equation in larger clinical cohorts.
Collapse
Affiliation(s)
- S J Mitchell
- S.J. Mitchell, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Freeman JT, Williamson DA, Heffernan H, Smith M, Bower JE, Roberts SA. Comparative epidemiology of CTX-M-14 and CTX-M-15 producing Escherichia coli: association with distinct demographic groups in the community in New Zealand. Eur J Clin Microbiol Infect Dis 2012; 31:2057-60. [PMID: 22271302 DOI: 10.1007/s10096-011-1540-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Accepted: 12/23/2011] [Indexed: 11/28/2022]
Abstract
Extended spectrum beta-lactamase producing E. coli (ESBL-EC) are an emerging public health issue. In New Zealand (NZ), bla (CTX-M-14) and bla (CTX-M-15) are the most common ESBL genes. Although many studies describe risk factors for ESBL-EC, few describe risk factors for specific ESBL genes. Between January 2006 and December 2007, we characterized 108 consecutive, non-duplicate isolates of ESBL-EC at the Auckland Hospital laboratory. Demographic and clinical data were recorded. Of the 108, 54.6% (59) were CTX-M-15-EC, 26.9% (29) were CTX-M-14-EC and 12.09% were CTX-M-9 (13). The remaining seven isolates carried CTX-M-3 (3; 2.7%), CTX-M-65 (2; 1.8%), CTX-M-27 (1; 0.9%) and CTX-M-57 (1; 0.9%). CTX-M-15-EC were more likely than CTX-M-14-EC to be fluoroquinolone-resistant (86.4% versus 32.4%; p=0.006) and to be non-susceptible to amoxicillin-clavulanate (84.7% versus 41.4%; p=0.0001). Patients with CTX-M-15-EC were more likely to be of Indian ethnicity (34.5% versus 0%; p=0.0012) and to have travelled recently (31.6% versus 4%; p=0.0088). Patients with CTX-M-14-EC were more likely to have Chinese or South-East Asian ethnicity (48.1% versus 5.2%; p<0.0001) and to have no history of either travel or prior hospital admission (44% versus 8.9%; p=0.0006). These data imply that CTX-M-15 and CTX-M-14 producing E. coli are associated with distinct demographic subgroups in NZ.
Collapse
Affiliation(s)
- J T Freeman
- Department of Clinical Microbiology, Auckland City Hospital, Auckland District Health Board, Auckland, New Zealand.
| | | | | | | | | | | |
Collapse
|
12
|
Williamson DA, Heffernan H, Sidjabat H, Roberts SA, Paterson DL, Smith M, Freeman JT. Intercontinental transfer of OXA-181-producing Klebsiella pneumoniae into New Zealand. J Antimicrob Chemother 2011; 66:2888-90. [DOI: 10.1093/jac/dkr396] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
13
|
Williamson DA, Roberts SA, Smith M, Heffernan H, Tiong A, Pope C, Freeman JT. High rates of susceptibility to ceftazidime among globally prevalent CTX-M-producing Escherichia coli: potential clinical implications of the revised CLSI interpretive criteria. Eur J Clin Microbiol Infect Dis 2011; 31:821-4. [PMID: 21894534 DOI: 10.1007/s10096-011-1380-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Accepted: 07/28/2011] [Indexed: 10/17/2022]
Abstract
The CTX-M family of extended-spectrum β-lactamases (ESBLs) is a significant global public health threat. The prevalence of specific bla (CTX-M) genes varies geographically, but bla (CTX-M-15) and bla (CTX-M-14) dominate in most countries. We applied the latest Clinical Laboratory Standards Institute (CLSI) interpretive criteria (M100-S20) to a diverse collection of ESBL-producing Escherichia coli strains obtained from clinical specimens in our laboratory. Whereas under previous CLSI recommendations all isolates in this strain collection would have been reported as ceftazidime-resistant, under the new recommendations, approximately 11% of CTX-M-15-producing E. coli and 93% of CTX-M-14-producing E. coli respectively tested as ceftazidime-susceptible. We also found that, whilst many CTX-M-14-producers had minimum inhibitory concentrations (MICs) less than the breakpoint of 4 mg/L, the MIC distribution for these strains was higher than that of wild-type E. coli, with one CTX-M-14-producing isolate having an MIC of >64 mg/L. Although the new CLSI recommendations imply that ceftazidime can be safely used to treat serious infections due to CTX-M-producing E. coli, clinical outcome data are lacking. Consequently, the widespread use of ceftazidime in this setting could have profound clinical implications.
Collapse
Affiliation(s)
- D A Williamson
- Department of Clinical Microbiology, Auckland City Hospital, Auckland, New Zealand
| | | | | | | | | | | | | |
Collapse
|
14
|
|
15
|
Abstract
BACKGROUND Energy or calorie restriction (CR) has consistently been shown to produce weight loss and have beneficial health effects in numerous species, including primates and humans. Most individuals, however, are unable to sustain weight losses induced through reductions in energy intake, potentially due to increased hunger levels. The effects that prolonged CR has on subjective aspects of appetite have not been well studied. Thus, the present study tested the effect of 6 months of caloric restriction on appetite in healthy, overweight men and women. METHODS Forty-eight overweight men and women with a body mass index (BMI; kg m(-2)) between 25-29.9 took part in a 6-month study and were randomised into one of four groups: healthy diet (control); 25% CR; 12.5% CR plus exercise (12.5% increased energy expenditure; CR + EX); low-calorie diet [LCD; 3724 kJ day(-1) (890 kcal day(-1)) until 15% of initial body weight was lost, then maintenance]. Appetite markers (i.e. hunger, fullness, desire to eat, etc.) were assessed weekly during a fasting state. RESULTS Body weight was significantly reduced in all three energy-restricted groups (CR = -10.4 +/- 0.9%; CR + EX = -10.0 +/- 0.8%; and LCD = -13.9 +/-0.7%), indicating that participants were adherent to their energy restriction regimen, whereas the healthy diet control group remained weight stable (control = -1.0 +/- 1.1%). Despite these significant weight losses, appetite ratings of participants in the three energy-restricted groups at month 6 were similar to the weight stable control group. CONCLUSIONS CR regimens with low fat diets producing significant weight losses have similar effects on appetite markers over a 6-month time period compared to a weight stable control group.
Collapse
Affiliation(s)
- S D Anton
- Pennington Biomedical Research Center, Baton Rouge, LA, USA.
| | | | | | | | | | | |
Collapse
|
16
|
Lloyd BD, Williamson DA, Singh NA, Hansen RD, Diamond TH, Finnegan TP, Allen BJ, Grady JN, Stavrinos TM, Smith EU, Diwan AD, Fiatarone Singh MA. Recurrent and Injurious Falls in the Year Following Hip Fracture: A Prospective Study of Incidence and Risk Factors From the Sarcopenia and Hip Fracture Study. J Gerontol A Biol Sci Med Sci 2009; 64:599-609. [DOI: 10.1093/gerona/glp003] [Citation(s) in RCA: 133] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
17
|
Anton SD, Martin CK, Redman L, York-Crowe E, Heilbronn LK, Han H, Williamson DA, Ravussin E. Psychosocial and behavioral pre-treatment predictors of weight loss outcomes. Eat Weight Disord 2008; 13:30-7. [PMID: 18319635 DOI: 10.1007/bf03327782] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
This study tested whether baseline behavioral and psychological variables predict weight and fat loss among overweight, non-obese individuals participating in a six-month calorie restriction trial. Participants (N=48) were randomly assigned to four groups, three of which included a calorie restriction program and one of which served as a healthy diet weight maintenance control. For the purposes of this study, data were analyzed only for participants assigned to the three calorie restriction groups (n=36). Ten psychological and behavioral measures were investigated through principal components factor analysis to examine whether these measures were assessing similar or distinct psychological and behavioral constructs. Based on the obtained six-factor solution, one measure from each domain was selected for inclusion in hierarchical regression analyses, which was used to test the relative importance of psychosocial and behavioral variables in predicting percent weight and fat loss over six months. After controlling for demographic and treatment variables, the behavioral and psychological measures of negative mood states, poor psychosocial functioning, and somatic symptoms were associated with less weight loss (R2=0.68, p<0.001) and fat loss (R2=0.65, p<0.001) over six months. Among overweight individuals, poor psychological adjustment, somatic symptoms, and negative mood states appear to form a psychosocial profile that is predictive of less weight and fat loss in calorie restriction programs.
Collapse
Affiliation(s)
- S D Anton
- Department of Aging and Geriatric Research, University of Florida, Gainesville, Florida, USA
| | | | | | | | | | | | | | | |
Collapse
|
18
|
Anton SD, Han H, Newton RL, Martin CK, York-Crowe E, Stewart TM, Williamson DA. Reformulation of the Children's Eating Attitudes Test (ChEAT): factor structure and scoring method in a non-clinical population. Eat Weight Disord 2006; 11:201-10. [PMID: 17272950 DOI: 10.1007/bf03327572] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
The primary aims of this study were to empirically test the factor structure of the Children's Eating Attitudes Test (ChEAT) through both exploratory and confirmatory factor analyses and to interpret the factor structure of the ChEAT within the context of a new scoring method. The ChEAT was administered to 728 children in the 2nd through 6th grades (from five schools) at two different time points. Exactly half the students were male and half were female. To the best of our knowledge, this is the first study to empirically test the merits of an alternative 6-point scoring system as compared to the traditionally used 4-point scoring system. With the new scoring procedure, the skewness for all factor scores decreased, which resulted in increased variance in the item scores, as well as the total ChEAT score. Since the internal consistency of two factors in a recently proposed model was not acceptable (<0.60), this model did not adequately fit our data. Thus, exploratory and confirmatory factor analyses were conducted. A 6-factor solution based on a 20-item version was found to best fit the data and have the best internal reliability. The six factors were labeled: 1) overconcern with body size, 2) dieting, 3) food preoccupation, 4) social pressure to gain weight, 5) vomiting, and 6) caloric awareness and control. The obtained factor solution had considerable overlap with the original factor analysis performed on the 26-item Eating Attitudes Test and with the factor structure of the ChEAT reported by previous investigations. Intercorrelations among the factors suggested three higher order constructs. These findings indicate that the ChEAT subscales may be sufficiently stable to allow use in non-clinical samples of children.
Collapse
Affiliation(s)
- S D Anton
- Pennington Biomedical Research Center, Louisiana State University, Baton Rogue, LA 70808, USA.
| | | | | | | | | | | | | |
Collapse
|
19
|
Anton SD, Newton RL, Sothern M, Martin CK, Stewart TM, Williamson DA. Association of depression with Body Mass Index, sedentary behavior, and maladaptive eating attitudes and behaviors in 11 to 13-year old children. Eat Weight Disord 2006; 11:e102-8. [PMID: 17075232 DOI: 10.1007/bf03327566] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
We examined the relation of different behavioral dimensions of depression with weight-related variables (BMI percentile, sedentary behavior, eating attitudes, and weight control behaviors) in children aged 11 to 13 years. Depression was assessed using the Children's Depression Inventory (CDI). Sedentary behavior was measured in 45 sixth grade students (23 boys and 22 girls) using a validated 24-hour recall instrument, the Self-Administered Physical Activity Checklist. BMI was calculated directly from measured height and weight (kg/m2). The Children's Eating Attitudes Test (ChEAT) was used to measure eating attitudes and weight control behaviors. There were not significant gender differences in reported minutes (142 vs. 91 minutes for boys vs. girls; p=0.25) of sedentary behavior (i.e., television watching and video game playing). The major finding of this study was that certain aspects of depression (i.e., interpersonal problems and feelings of ineffectiveness) were correlated with higher levels of sedentary behavior in children aged 11 to 13. A factor analysis of the study variables indicated that most dimensions of depression, sedentary behavior, and body size represent distinct but correlated behavioral dimensions. This study provides support for a link between specific aspects of depression (i.e., interpersonal problems and feelings of ineffectiveness) and sedentary behavior in children.
Collapse
Affiliation(s)
- S D Anton
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA.
| | | | | | | | | | | |
Collapse
|
20
|
Abstract
This cross-sectional research study tested the hypothesis that body image estimates of African-American females differ as a function of age. To test this hypothesis, body image estimates of 379 African-American females, ranging in age from 16 to 96 years, were contrasted as a function of age group, while statistically controlling body mass index. Three body size estimates, current body size, ideal body size, and reasonable body size were measured using the Body Image Assessment for Obesity. The discrepancies between current and ideal body size estimates and between current and reasonable body size estimates were also analyzed to assess for differences in body size dissatisfaction. The study found that younger African-American women (16 to 35 years) differed from older African-American women (>35 years) on measures of body size dissatisfaction. Women in the age range of 26 to 35 years reported higher estimates of current body size in comparison to women older than 35 years. The youngest age group (16 to 25 years) reported thinner ideal body size goals in comparison to women who were slightly older (26 to 35 years) and women who were older than 75 years. The pattern of body image estimates across a large age range suggests that younger African-American women, in comparison to older African-American women, may have body images that may make them more susceptible to eating disorders.
Collapse
Affiliation(s)
- D A Williamson
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70808, USA.
| | | | | | | | | |
Collapse
|
21
|
Williamson DA, Martin PD, White MA, Newton R, Walden H, York-Crowe E, Alfonso A, Gordon S, Ryan D. Efficacy of an internet-based behavioral weight loss program for overweight adolescent African-American girls. Eat Weight Disord 2005; 10:193-203. [PMID: 16277142 DOI: 10.1007/bf03327547] [Citation(s) in RCA: 107] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE This randomized controlled trial tested the efficacy of an internet-based lifestyle behavior modification program for weight management in African-American girls. DESIGN African-American girls were randomly assigned to an interactive behavioral internet program or an internet health education program, the control condition. The behavioral intervention included internet counseling and was highly interactive. The control intervention was a passive (non-interactive) educational program. Parents were also participants in the study. Participants in both treatment groups met in face-to-face sessions on four occasions over the first 12 weeks of a 6-month intervention. SUBJECTS The study enrolled 57 African-American adolescent girls (ages 11 to 15 years) who were overweight or obese and had at least one biological parent who was obese [body mass index (BMI) >30 kg/m2]. Of the 57 participants, 50 (88%) completed the 6-month trial. MEASUREMENTS Outcome data, including BMI, body weight, body composition, dietary intake, and weight loss behaviors were collected at baseline and 6-months later. A computer server tracked utilization of the websites. Participation in the program was measured by number of "hits" on the website. RESULTS Compared to the control condition, adolescents in the behavioral treatment lost more body fat (group difference =1.6% body fat) and parents lost significantly more body weight (group difference =2.1 kg). Utilization of the behavioral website by adolescents and parents was associated with positive outcome. Dietary fat intake was lowered for adolescents and parents in the behavioral treatment group. CONCLUSION An internet-based behavioral intervention was superior to internet-based health education and yielded decreased body fat for adolescent girls and decreased body weight for parents.
Collapse
Affiliation(s)
- D A Williamson
- Pennington Biomedical Research Center, Baton Rouge, LA, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Abstract
OBJECTIVE The primary aim of this study was to examine the health- and appearance-related concerns of young African-American and Caucasian females. RESEARCH METHODS Participants were twenty Caucasian and twenty African-American college women, who were matched on age and BMI. All participants were administered the Multidimensional Body-Self Relations Questionnaire (MBSRQ), a demographics instrument, and a short inventory to assess concerns about health, appearance, and weight management, in a single testing session; height and weight data were self-reported. RESULTS African-American women and Caucasian women were not significantly different in their level of health consciousness or perception of health; however, African-American women were significantly more satisfied with their physical appearance in comparison to Caucasian women. Among African-American women, perception of health and level of health consciousness were highly related; this relationship was not found in Caucasian women. In addition, perception of health was related to satisfaction with appearance in both groups, although the relationship was stronger among African-Americans. Among Caucasian women, satisfaction with physical appearance was highly correlated with perception of weight status (from underweight to very overweight); this relationship was not found among African-American females. An inverse relationship between body mass index (BMI) and appearance evaluation was found only for Caucasian females. DISCUSSION These findings suggest that, on the whole, young African-American and Caucasian college females report similar evaluations of health and values placed on appearance and health, and differ primarily in terms of satisfaction with physical appearance.
Collapse
Affiliation(s)
- E E York-Crowe
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70808, USA
| | | |
Collapse
|
23
|
Abstract
Assessment of binge eating has been criticized because of serious doubts concerning the accuracy of self-report. This experiment tested the validity of a laboratory test meal as an indicator of binge eating. Eight individuals diagnosed with binge-eating disorder (BED), eight obese non-binge-eaters, and eight normal-weight non-binge-eaters ate a test meal under conditions designed to increase the likelihood of inducing a binge episode. Non-binge-eaters, regardless of weight, felt in control of their eating and ate a relatively small amount of the test meal, while participants with BED ate significantly more food and felt significantly more out of control. Eating behavior during test meals can be a useful indicator of BED diagnostic status and may be a useful method for objectively defining binge eating.
Collapse
Affiliation(s)
- D A Anderson
- Department of Psychology, University at Albany, SUNY, Social Sciences 112, Albany, NY 12222, USA.
| | | | | | | |
Collapse
|
24
|
Abstract
OBJECTIVE The primary objective of this study was to test the comparability of digital photography and visual estimation procedures for estimating food intake. RESEARCH METHODS AND PROCEDURES The study sample included 71 breakfast meals and 59 lunch meals eaten in a university cafeteria during a single day. A total of 66 different foods were employed as test foods that could be selected by the students. Food selections and plate waste, as estimated by digital photography and visual estimation, were compared. For digital photography, three observers independently estimated portion sizes of each food item based upon digital photographs. One observer estimated portion sizes in the cafeteria setting, using visual estimation, a method that has been validated in other studies. RESULTS To test the accuracy of the two procedures for measuring food intake, the estimates of food weights derived from both procedures were compared using Bland-Altman regression. In comparison to visual estimation, the digital photography method yielded comparable estimates of food selections, plate waste, and total food intake for seven of nine comparisons. The two methods of estimating food portions yielded comparable results for most (78%) types of foods. The two methods also yielded similar variability. DISCUSSION These findings suggest that the digital photography method is an alternative to the traditional method of estimating food intake via direct observation.
Collapse
Affiliation(s)
- D A Williamson
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA.
| | | | | | | | | | | |
Collapse
|
25
|
Abstract
This paper used accounts of professional caregivers to HIV/AIDS patients in Lomé, Togo, West Africa to explore the impacts of cultural, institutional and socio-economic factors in the fight against HIV/AIDS. Thirteen health professionals and 17 non-health professionals who work with people living with HIV/AIDS were interviewed in June and July 2002 in Lomé, Togo. The study found that, in Togo there are some cultural, socio-economic and institutional practices that put Togolese at risk of contracting HIV and complicate the care of those who become infected. People with HIV/AIDS face socio-economic, emotional and psychological battles as they attempt to deal with their physical health and the social reactions to such a stigmatizing disease. Thus, in order to contain the spread of HIV/AIDS, people living with HIV/AIDS, family caregivers, traditional healers as well as the public must be educated about the importance of preventing the disease and how each group can help achieve success in its control. Interventions in prevention and care should be designed with an awareness of these structural factors that contribute to the spread of AIDS and compromise the quality of care given to those who become infected.
Collapse
Affiliation(s)
- A R Moore
- Department of Sociology, University of North Texas, Denton 76203, USA.
| | | |
Collapse
|
26
|
Whisenhunt BL, Williamson DA, Netemeyer RG, Andrews C. Health risks, past usage, and intention to use weight loss products in normal weight women with high and low body dysphoria. Eat Weight Disord 2003; 8:114-23. [PMID: 12880188 DOI: 10.1007/bf03325000] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
OBJECTIVE There are many health risks involved with the use of weight loss products by normal weight women. The mass media may compound this problem through the promotion of weight loss products and a thin body size. This study tested women's perceptions of different weight loss product ads to determine if body dysphoria (i.e., an over concern with body size and shape in normal weight people) was associated with risk beliefs, past behaviors, and intention toward using weight loss products. METHOD Normal weight women (age range = 18-41 yr), who were classified as either high (n=45) or low (n=43) on a measure of body dysphoria, rated different weight loss products according to their perception of health risks, past behavior, and their intention to consume the products. These products were a dietary fat substitute (olestra), a prescription obesity medication (sibutramine), and an over-the-counter appetite suppressant (phenylpropanolamine). RESULTS High body dysphoric women reported higher intentions to use the products as well as increased prior use of two of the three weight loss products. High body dysphoric women did not believe that these weight loss products were harmless. They recognized potential health risks associated with using such products, but nonetheless, expressed intention to use these weight loss products at a higher frequency. Also, several variables related to body image were found to effectively discriminate normal weight women at risk for abusing weight loss products. DISCUSSION This study found that women who do not need to lose weight but have significant body image concerns were willing to use potentially harmful weight loss products despite the knowledge that such products might pose significant health risks. Techniques utilized by advertising regulatory agencies such as warning labels did not have a strong deterrent effect for stated intentions to use the products. Implications of these findings for public health policy issues were discussed.
Collapse
Affiliation(s)
- B L Whisenhunt
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70808, USA
| | | | | | | |
Collapse
|
27
|
White MA, Kohlmaier JR, Varnado-Sullivan P, Williamson DA. Racial/ethnic differences in weight concerns: protective and risk factors for the development of eating disorders and obesity among adolescent females. Eat Weight Disord 2003; 8:20-5. [PMID: 12762621 DOI: 10.1007/bf03324985] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE This study compared African American and Caucasian adolescent girls on measures of appearance concerns, body-contingent self-esteem, pressures for thinness, and dieting behaviour. Also, correlations among these measures were contrasted across the two ethnic groups. METHOD African American (n = 32) and Caucasian (n = 29) adolescent girls completed a series of self-report measures concerning dieting behaviour, perceived pressures for thinness, self-esteem, and perceptions of physical appearance. RESULTS Across all measures, Caucasian girls endorsed more disturbed eating behaviors and beliefs about body shape and weight. Dieting among Caucasian girls was correlated with preoccupation with body shape. Among African American girls dieting behaviour was unrelated to concerns about body shape. DISCUSSION These findings support the hypothesis that in comparison to Caucasian girls, African American girls may be at lessened risk for developing eating disorders but may be at greater risk for developing obesity. This conclusion is based upon the findings of higher levels of eating disorder symptoms among Caucasian girls and the relative absence of significant correlations between dieting and body shape and appearance concerns among African American girls.
Collapse
Affiliation(s)
- M A White
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70808, USA
| | | | | | | |
Collapse
|
28
|
Abstract
This study investigated the presence of the False Consensus Effect (FCE) with body and shape-related attitudes in 30 normal weight women who scored high or low on a measure of concern with body shape. The participants were asked to rate depressive, positive, neutral, and body shape self-statements for relevance to self and to others. They also estimated the percentage of individuals that would agree with each attitudinal statement. Women with high body shape concerns rated themselves and others as significantly more likely to agree with the statements expressing such concerns than those with low concerns. They also believed that a significantly higher percentage of others would favor those attitudes. This pattern of findings is supportive of the presence of a FCE in normal weight women preoccupied with body shape and size.
Collapse
Affiliation(s)
- S L Muller
- Louisiana State University, Department of Psychology. Audubon Hall, Baton Rouge, LA, USA
| | | | | |
Collapse
|
29
|
Abstract
Worry content as assessed by using a modified Worry Domains Questionnaire (WDQ) was compared among participants diagnosed with a depressive disorder, generalized anxiety disorder (GAD), and both a depressive disorder and GAD. A discriminant function analysis of worry domains yielded two significant functions. The worry domains Lack of Confidence, Aimless Future, Relationships, and Financial Concerns loaded significantly on Function 1, which was termed "Depressive Worries." The worry domain Loss of Control loaded significantly on Function 2, which was termed "Anxious Worries." The three participant groups differed in their pattern of worries in a way that lends support to the content-specificity hypothesis for both depression and anxiety. In addition, multiple regression analysis indicated that WDQ domain scores (in particular the Aimless Future domain) predicted the severity of depressive symptoms even after the variance contributed by anxiety symptoms was removed from the analysis. These findings suggest that the content of a person's worries may be significantly associated with the presence of depression, anxiety, or comorbid depression and anxiety.
Collapse
Affiliation(s)
- G J Diefenbach
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA.
| | | | | | | | | | | |
Collapse
|
30
|
Barbin JM, Williamson DA, Stewart TM, Reas DL, Thaw JM, Guarda AS. Psychological adjustment in the children of mothers with a history of eating disorders. Eat Weight Disord 2002; 7:32-8. [PMID: 11933911 DOI: 10.1007/bf03354427] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
In order to test the impact of mothers' eating disorders (EDs) on their children's psychological adjustment, we recruited mothers belonging to three different populations: women with eating disorders, women with depression, and normal controls. The parents responded to self-report inventories relating to psychological adjustment of the parent and child. The study found that the psychological adjustment of the children of mothers with a history of ED was not different from that of the children of mothers in the normal control group, although mothers described significant pregnancy and birth complications, parenting stress, and symptoms of clinical depression. The children of mothers with a history of depression had significantly greater psychological problems in comparison with those of the children of mothers in the other two groups. The results are interpreted in the context of the protective factors that may have buffered the effects of maternal psychopathology in children of mothers with a history of ED.
Collapse
Affiliation(s)
- J M Barbin
- Department of Psychology, Louisiana State University, Baton Rouge, USA
| | | | | | | | | | | |
Collapse
|
31
|
Thaw JM, Williamson DA, Martin CK. Impact of altering DSM-IV criteria for anorexia and bulimia nervosa on the base rates of eating disorder diagnoses. Eat Weight Disord 2001; 6:121-9. [PMID: 11589414 DOI: 10.1007/bf03339761] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
The diagnostic criteria used to define eating disorders have been the focus of debate for many years. The primary aim of this study was to evaluate the impact of altering DSM-IV diagnostic criteria upon the base rates of anorexia nervosa (AN), bulimia nervosa (BN) and eating disorder not otherwise specified (EDNOS). Five controversial criteria were systematically modified and the impact of these changes on base rates of full-syndrome and partial-syndrome eating disorders was assessed in 193 patients referred to two specialty eating disorder clinics. Modification of a single criterion resulted in relatively small changes in base rates of AN and BN, whereas modification of the two severity criteria led to more substantial changes. These findings have significant implications for future modifications of the DSM classification.
Collapse
Affiliation(s)
- J M Thaw
- Louisiana State University Pennington Biomedical Research Center, Baton Rouge 70808, USA
| | | | | |
Collapse
|
32
|
Womble LG, Williamson DA, Martin CK, Zucker NL, Thaw JM, Netemeyer R, Lovejoy JC, Greenway FL. Psychosocial variables associated with binge eating in obese males and females. Int J Eat Disord 2001; 30:217-21. [PMID: 11449457 DOI: 10.1002/eat.1076] [Citation(s) in RCA: 87] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study tested a psychosocial model of binge eating symptoms in obese men and women. Predictor variables included depression, dietary restraint, self-esteem, weight cycling, history of teasing, body dissatisfaction, and neuroticism. METHOD Participants (N = 808) completed a packet of self-report questionnaires. RESULTS Weight cycling, teasing about weight and shape, body dissatisfaction, negative affect, and dietary restraint comprised the best fitting models (original and cross-validation) for binge eating in women and men. These variables explained 61-72% of the variance in symptoms of binge eating in the samples of men and 70% of the variance in the samples of women. Although the male and female models were mostly similar, notable differences between them were found. DISCUSSION The variables that comprise these etiological models should be considered in the development of prevention programs for obese binge eaters. Longitudinal studies, however, are needed to examine these etiological paths and to test for causal relationships.
Collapse
Affiliation(s)
- L G Womble
- Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA
| | | | | | | | | | | | | | | |
Collapse
|
33
|
Reas DL, Schoemaker C, Zipfel S, Williamson DA. Prognostic value of duration of illness and early intervention in bulimia nervosa: a systematic review of the outcome literature. Int J Eat Disord 2001; 30:1-10. [PMID: 11439404 DOI: 10.1002/eat.1049] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Early intervention is often regarded as an important step for the prevention of a chronic eating disorder. The primary aim of this review was to systematically evaluate the outcome literature and to better describe the effects of early intervention on the course of bulimia nervosa. METHOD Twenty-four follow-up studies were subjected to nine "best-evidence" criteria for methodological soundness. Of these 24 studies, 5 met all methodological criteria and were considered in more detail. RESULTS Only one of these five studies found a significant association between duration of illness and outcome. These studies were re-examined to exclude studies that included patients who were not first admissions in order to distinguish between the effect of duration of illness versus early intervention. This re-examination excluded four of the five studies, and the remaining study provided no data regarding prior treatment. DISCUSSION Based on this selection of studies, it was concluded that there is no consistent evidence to support that early intervention necessarily implies a better long-term outcome. Due to the multiple methodological problems that plague follow-up studies, future research would be improved by employing designs that directly test the impact of early versus late intervention.
Collapse
Affiliation(s)
- D L Reas
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | | | | | | |
Collapse
|
34
|
McCarthy-Larzelere M, Diefenbach GJ, Williamson DA, Netemeyer RG, Bentz BG, Manguno-Mire GM. Psychometric properties and factor structure of the Worry Domains Questionnaire. Assessment 2001; 8:177-91. [PMID: 11428697 DOI: 10.1177/107319110100800206] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Worry Domains Questionnaire (WDQ) is a content-based measure of nonpathological worry. The current study investigates an adapted WDQ for clinical assessment. The WDQ was completed by 570 participants (286 clinical, 284 nonclinical). Internal consistency of the WDQ domains was found to be adequate. Clinical participants obtained significantly higher WDQ scores than control participants. WDQ scores were moderately correlated with several clinical self-report measures. A seven-factor structure and a higher order worry factor model were separately subjected to structural equation modeling in the clinical sample. The factor groupings originally outlined by the scale's authors (with minor revisions) provided the best description of the clinical data set. Evidence of differences in the worry factor structures of clinical and control samples did emerge. This study provides initial support of the psychometric suitability of the adapted WDQ for use in clinical populations.
Collapse
|
35
|
Abstract
No known pathophysiological mechanism can explain the majority of cases of blepharospasm, i.e. spasm of the orbicularis oculi muscle; it may also affect the lower face, neck and jaw--Meige syndrome. Only symptomatic treatment is possible, and surgery should be a last resort for severe cases. Much more clinical research will be required before promising behavioural interventions, including biofeedback, can be considered treatments of choice.
Collapse
|
36
|
Womble LG, Williamson DA, Greenway FL, Redmann SM. Psychological and behavioral predictors of weight loss during drug treatment for obesity. Int J Obes (Lond) 2001; 25:340-5. [PMID: 11319630 DOI: 10.1038/sj.ijo.0801551] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2000] [Revised: 09/04/2000] [Accepted: 10/09/2000] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study investigated whether baseline eating behavior, emotions, and body image were significant predictors of change in body mass index (BMI) over 6 month and 12 month time intervals for individuals enrolled in a weight loss program that combined appetite suppressant medications and behavior therapy for obesity. METHOD Participants were asked to complete self-report questionnaires at baseline, 6 months, and 12 months. In addition, their height and weight were measured and they were administered a body image assessment procedure at each time interval. RESULTS At baseline, perceived hunger, dietary restraint, current body size, and trait anxiety were important components in a model for prediction of weight loss at 6 months. Perceived hunger, dietary restraint, and current body size as measured at baseline were important components in the prediction of weight loss at 12 months. These predictive variables, together with gender and initial BMI, accounted for 48.6% of the variance in weight loss at 6 months and 51.7% of the variance in weight loss at 12 months. DISCUSSION These findings suggest that scores on certain paper and pencil tests may be useful as predictors of success or failure for individuals entering a weight loss program using pharmacological and behavioral interventions.
Collapse
Affiliation(s)
- L G Womble
- Pennington Biomedical Research Center, Louisiana State University, 6400 Perkins Road, Baton Rouge, LA 70808, USA.
| | | | | | | |
Collapse
|
37
|
Stewart TM, Williamson DA, Smeets MA, Greenway FL. Body Morph Assessment: preliminary report on the development of a computerized measure of body image. Obes Res 2001; 9:43-50. [PMID: 11346666 DOI: 10.1038/oby.2001.6] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To develop a prototype of the Body Morph Assessment (BMA), and to test the reliability and validity of this new measure of body image. The BMA is a realistic and relatively simple procedure that uses computer morphing for the assessment of body image. For the purposes of this preliminary study, a prototype of the BMA was developed for usage with white women ranging from very thin to obese. RESEARCH METHODS AND PROCEDURES A total of 72 subjects participated in tests of reliability, content, and convergent validity of the BMA. RESULTS The reliability and validity of the BMA was supported by the results of this study. In a test of convergent validity, the measures of current, ideal, and reasonable body size were positively correlated with their equivalents from a similar body image assessment procedure. In addition, reliability coefficients were found to be satisfactory for all variables. Participants found the human figural stimuli to be realistic. DISCUSSION These preliminary findings support the reliability and validity of the BMA with white women. Given these positive findings, we plan to extend the procedure to males and to other racial and ethnic groups.
Collapse
Affiliation(s)
- T M Stewart
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, 70808, USA
| | | | | | | |
Collapse
|
38
|
Abstract
OBJECTIVE The purpose of this investigation was to establish the criterion validity of the Multiaxial Assessment of Eating Disorders Symptoms (MAEDS). The MAEDS is a brief, comprehensive, self-report measure for the evaluation of eating disorders treatment outcome. It assesses six symptoms associated with eating disorders with subscales for binge eating, purgative behavior, avoidance of forbidden foods, restrictive eating, fear of fatness, and depression. METHOD To establish criterion validity, we compared the subscale scores of the MAEDS across four eating disorder diagnoses, specified by subtype (bulimia nervosa, purging type; anorexia nervosa, binge-eating/purging type; anorexia nervosa, restricting type; and binge eating disorder). Participants who did not meet the full diagnostic criteria for an eating disorder, but who did meet criteria for a partial syndrome eating disorder, were grouped with the full eating disorder diagnostic subtypes. RESULTS The criterion validity of the MAEDS was supported by the pattern of subscale scores for the different eating disorder diagnostic groups. Also, with few exceptions, persons diagnosed with anorexia nervosa, bulimia nervosa, and binge eating disorder, in comparison to subthreshold cases of anorexia nervosa, bulimia nervosa, and binge eating disorder, had equivalent scores on the subscales of the MAEDS. DISCUSSION These findings support the criterion validity of the MAEDS and add to a growing literature that questions differences in severity of eating disorder symptoms in full syndrome versus partial syndrome cases.
Collapse
Affiliation(s)
- C K Martin
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | | | | |
Collapse
|
39
|
Abstract
OBJECTIVE A new measure of body image, named the body image assessment for obesity (BIA-O) was developed and tested for reliability and validity in a sample of 1,209 adult men and women. Separate BIA-O procedures were developed for men and women. Current, ideal and reasonable body image estimates of Caucasian and African-American men and women were compared. METHOD Figural stimuli of males and females were developed for body sizes ranging from very thin to very obese in 18 increments. Participants selected figures that represented estimates of current, ideal and reasonable (a body size that could be maintained over time) body size. Some participants (n=641) also completed two measures of body dissatisfaction in a test of the validity of the BIA-O as a measure of body dissatisfaction. A sample of 77 participants was administered the BIA-O on two occasions to test the test-retest reliability of the BIA-O. RESULTS The reliability of the BIA-O was supported by test-retest reliability coefficients which ranged from 0.65 to 0.93. Concurrent validity of the discrepancy between current and ideal and current and reasonable body size estimates was supported by positive correlations with two measures of body dissatisfaction. The BIA-O body size estimates of Caucasians and African-Americans, controlled for age and BMI, were compared. As BMI increased, Caucasian men and women were found to select larger current body size estimates in comparison to African-Americans. DISCUSSION The reliability and validity of the BIA-O were supported. Greater body size dissatisfaction in obese Caucasians, relative to African-Americans of the same size, may be a function of biased estimates of current body size.
Collapse
Affiliation(s)
- D A Williamson
- Louisiana State University, Pennington Biomedical Research Center, Baton Rouge 70808, USA.
| | | | | | | | | | | | | |
Collapse
|
40
|
Abstract
Three groups of women: eating disorder, body dysphoric controls, and nonsymptomatic controls, participated in an experiment testing hypotheses derived from cognitive-behavioral theories of eating disorders. In phase 1, participants encoded ambiguous information via instructions to imagine themselves in a variety of ambiguous situations that involved two types of information: body-related or health-related. On a subsequent memory task, participants in the eating disorder group and the body dysphoric control group recalled imagery of the body-related situations with a fatness interpretation and participants in the nonsymptomatic control group recalled imagery with a thinness interpretation. The three groups did not differ in their interpretation of the health-related situations. In phase 2, participants were instructed to imagine themselves in each body-related situation, but were explicitly instructed to imagine the scenes with either a positive or negative interpretation. Results indicated that the eating disorder and body dysphoric groups were able to change their interpretation of body-related information when instructed to do so.
Collapse
Affiliation(s)
- D A Williamson
- Louisiana State University, Pennington Biomedical Research Center, Baton Rouge, USA
| | | | | | | |
Collapse
|
41
|
Williamson DA, Barenberg AM, Coleman CA, Benson DR. Guest dechlorination and covalent capture following photoexcitation of inclusion complexes in water. Chemosphere 2000; 40:1443-1446. [PMID: 10789986 DOI: 10.1016/s0045-6535(99)00330-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Photoexcitation of complexes between cyclophane 1 and 1- or 2-chloronaphthalene in aqueous solution leads to rapid dechlorination of the guest, a reaction driven by electron transfer from host to excited guest. The main photoproducts contain a naphthyl group covalently attached to the host framework. The results may lead to new approaches for remediating water contaminated with chlorinated aromatic compounds.
Collapse
Affiliation(s)
- D A Williamson
- Department of Chemistry, University of Kansas, Lawrence 66045-0046, USA
| | | | | | | |
Collapse
|
42
|
Smith CF, Williamson DA, Womble LG, Johnson J, Burke LE. Psychometric development of a multidimensional measure of weight-related attitudes and behaviors. Eat Weight Disord 2000; 5:73-86. [PMID: 10941605 DOI: 10.1007/bf03327482] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Most weight control programs facilitate weight loss by encouraging participants to adopt healthy eating patterns and increase physical activity. There is a need for a relatively brief measure of eating habits and physical activity that could be used to evaluate changes in behavior during weight loss treatment. The purpose of this series of four studies was to develop and validate such a measure, which was subsequently named the Weight Loss Behavior Scale (WLBS). Study 1 (n = 533) included item and scale development and examination of the WLBS's factor structure and internal consistency. Study 2 (n = 226) evaluated the test-retest reliability and convergent validity of its subscales. Study 3 examined their reliability and internal consistency scales in a predominantly overweight sample (n = 36). Study 4 evaluated the WLBS as a treatment outcome measure in a weight loss intervention (n = 50). Study 1 found that the WLBS contained five internally consistent and stable factors: 1) Concern with Dieting and Weight, 2) Exercise, 3) Overeating, 4) Avoidance of Fattening Foods and Sweets, and 5) Emotional Eating. Study 2 found convergent validity for the WLBS by assessing the correlation of its factors/scales with established inventories of comparable constructs, e.g., dietary restraint, disinhibited eating, and physical activity. Test-retest reliability of the five scales was also supported in this second study. In Study 3, support for the internal consistency and test-retest reliability of the WLBS among overweight individuals was found. Study 4 found that all scales significantly changed in the expected directions after a 5-month behavioral weight loss treatment. The findings from this series of studies suggest that the WLBS is a reliable and valid self-report inventory of cognitive and behavioral scales associated with weight control that can be utilized as an outcome measure for weight loss interventions.
Collapse
Affiliation(s)
- C F Smith
- University of Pittsburgh, Western Psychiatric Institute and Clinic, USA
| | | | | | | | | |
Collapse
|
43
|
Abstract
OBJECTIVE The purpose of this study was to investigate long-term outcome and prognosis in a bulimic and subthreshold bulimic sample. METHOD In a follow-up study, 44 patients diagnosed with bulimia nervosa and subthreshold bulimia nervosa were contacted after an average follow-up period of 9 years. RESULTS Results revealed that 72.7% (n = 32) of the participants were recovered at the time of follow-up. An investigation of prognostic variables showed that good outcome was associated with a shorter duration of illness, which was defined as the time between onset of symptoms and first treatment intervention. If participants were initially treated within the first few years of the illness, the probability of recovery was above 80%. However, if they were initially treated 15 years or more after the onset of the illness, the probability of recovery fell below 20%. DISCUSSION This finding suggests that early identification of bulimia nervosa may be a very important factor in preventing a chronic eating disorder.
Collapse
Affiliation(s)
- D L Reas
- Department of Psychology, Louisiana State University, Baton Rouge, LA 70808, USA
| | | | | | | |
Collapse
|
44
|
Abstract
This review explores several aspects of trichotillomania relevant to clinical theory and practice. It is concluded that research outlining the phenomenology and patterns of comorbidity of trichotillomania have been advanced significantly in recent years. However, no current diagnostic category appropriately classifies trichotillomania. Research with nonclinical populations suggests that trichotillomania is more common than previously believed and that additional epidemiological research is warranted. Continued elaboration of existing etiological models incorporating varying theoretical perspectives is also encouraged. Assessment of trichotillomania could also be improved by the continued development of reliable and valid standardized measures. This article reviews both pharmacological and psychological treatments for trichotillomania, with an emphasis on habit-reversal training. Though some interventions appear effective in the short-term, reported relapse rates are high and future research on treatment for trichotillomania should focus on improving long-term outcomes. It is clear that despite a recent flux of research centering on trichotillomania, significant challenges for understanding and treating this psychological disorder still exist for researchers and clinicians. Based on this review of the literature, and on our clinical experience with trichotillomania, we propose directions for future research with this underserved psychiatric group.
Collapse
|
45
|
Abstract
The Psychosocial Risk Factors Questionnaire (PRFQ) was developed to measure perceived attractiveness, concern about physical appearance, and social pressure for thinness. These variables have been identified as correlates of eating disorder symptoms. The PRFQ has four subscales: Social Pressure for Thinness, Media Pressure for Thinness, Concern for Physical Appearance, and Perception of Physical Appearance. This study assessed its reliability and validity. Seventy-two women enrolled in undergraduate psychology courses completed the PRFQ and measures selected to assess the concurrent validity of its four subscales. Its test-retest reliability was tested in a subsample of 60 women. Support was found for the test-retest reliability, internal consistency and construct validity of all four subscales.
Collapse
Affiliation(s)
- B L Whisenhunt
- Louisiana State University, Department of Psychology, Baton Rouge 70803, USA
| | | | | | | |
Collapse
|
46
|
Abstract
Research testing the predictions of cognitive-behavioral theory related to the psychopathology of eating disorders has lagged behind treatment outcome research. Central to cognitive theories of eating disorders is the hypothesis that beliefs and expectancies pertaining to body size and to eating are biased in favor of selectively processing information related to fatness/thinness, dieting, and control of food intake or body weight. In recent years, controlled investigations of the predictions of cognitive theories of eating disorders have yielded empirical support for these theories. This paper reviews research which has tested the predictions of cognitive-behavioral theory and discusses the implications of these findings for the treatment of eating disorders. Understanding of information processing biases may assist the clinician in understanding a range of psychopathological features of anorexia and bulimia nervosa, including denial, resistance to treatment, and misinterpretation of therapeutic interventions.
Collapse
Affiliation(s)
- D A Williamson
- Department of Psychology, Louisiana State University, Baton Rouge 70803, USA
| | | | | | | |
Collapse
|
47
|
Abstract
Binge eating disorder (BED) is a syndrome marked by recurrent episodes of binge eating, in the absence of the regular use of inappropriate compensatory behaviors. Since the inclusion of BED in DSM-IV as a Diagnostic Category in Need of Further Research, a great deal of research has been conducted. This paper reviews research on BED since publication of DSM-IV in 1994. We conclude that questions about the definition of BED persist. Furthermore, recent studies which have strictly used the DSM-IV definition of BED have found that the full syndrome is found in less than 3% of obese adults seeking weight loss treatment and occurs in less than 1% of the general adult population. Binge eating is a common symptom associated with obesity, however. BED may be conceptualized as a psychiatric syndrome or it may be viewed as a behavioral symptom associated with obesity. We conclude that clarification of this conceptual issue is needed if research on BED is to progress.
Collapse
Affiliation(s)
- D A Williamson
- Louisiana State University, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | | |
Collapse
|
48
|
Abstract
This study was designed to test the hypothesis that different types of dieting strategies are associated with different behavioral outcomes by investigating the relationship of dieting behaviors with overeating, body mass and mood. A sample of 223 adult male and female participants from a large community were studied. Only a small proportion of the sample (18%) was seeking weight loss treatment, though almost half (49.3%) of the subjects were significantly overweight (body mass index, BMI>30). Subjects were administered questionnaires measuring dietary restraint, overeating, depression and anxiety. Measurements of height and weight were also obtained in order to calculate BMI. Canonical correlation was performed to evaluate the relationship of dietary restraint variables with overeating variables, body mass, depression and anxiety. The strongest canonical correlation (r=0.65) was the relationship between flexible dieting and the absence of overeating, lower body mass and lower levels of depression and anxiety. The second strongest canonical correlation (r=0.59) associated calorie counting and conscious dieting with overeating while alone and increased body mass. The third canonical correlation (r=0.57) found a relationship between low dietary restraint and binge eating. The results support the hypothesis that overeating and other adverse behaviors and moods are associated with the presence or absence of certain types of dieting behavior.
Collapse
Affiliation(s)
- C F Smith
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70803, USA
| | | | | | | |
Collapse
|
49
|
Anderson DA, Williamson DA, Duchmann EG, Gleaves DH, Barbin JM. Development and validation of a multifactorial treatment outcome measure for eating disorders. Assessment 1999; 6:7-20. [PMID: 9971879 DOI: 10.1177/107319119900600102] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this investigation was to develop a brief self-report inventory which could be used to evaluate treatment outcome for anorexia and bulimia nervosa. The Multifactorial Assessment of Eating Disorders Symptoms (MAEDS) was constructed to measure six symptom clusters which have been found to be central to the eating disorders: depression, binge eating, purgative behavior, fear of fatness, restrictive eating, and avoidance of forbidden foods. The factor structure of the MAEDS was found to be stable and it was found to have satisfactory reliability and validity. Normative data were collected so that raw scores could be converted to standardized scores. While still in the experimental stages, the MAEDS shows promise as a valid and economical measure of treatment interventions for anorexia and bulimia nervosa.
Collapse
Affiliation(s)
- D A Anderson
- Louisiana State University, Baton Rouge, 70803-5501, USA
| | | | | | | | | |
Collapse
|
50
|
Abstract
While many studies have shown that individuals under-estimate caloric intake, few studies have examined how individuals estimate intake when using other units of measurement (e.g. cups, ounces). Forty-one women (21 obese, 20 normal weight) ate a test meal of Häagen-Dazs chocolate ice cream and were asked to estimate the amount they ate in both calories and cups. As expected, participants under-estimated intake when asked to estimate how much they ate in calories, but considerably over-estimated their intake when measured in cups. Thus, individuals can both under- and over-estimate how much of the same food they have eaten, depending on the unit they are asked to use for estimation. Obesity and eating disorders treatment programs should take into account the tendency to over-estimate volumetric portions as well as under-estimate caloric intake.
Collapse
Affiliation(s)
- D A Anderson
- University of Albany, State University of New York, Department of Psychology, 12222, USA
| | | | | | | |
Collapse
|