Factor Structure of the Anorexia Bulimia Inventory

The Anorexia Bulimia Inventory, a recently developed self-report questionnaire for the assessment of eating disorders, addresses two major limitations found in existing self-report eating disorder inventories. First, it comprehensively assesses the diagnostic symptoms of both bulimia and anorexia nervosa; and second, it assesses the frequently cooccurring problem areas (e.g., depression, anergia) that may be targeted in treatment planning for eating disorders. Although initial research on the psychometrics of the instrument appears promising, no research has yet investigated its factor structure. Therefore, the goal of the present study was to investigate the factor structure of the Anorexia Bulimia Inventory. Principal axis factor analysis with a varimax rotation was used on a combined clinical and nonclinical sample. The overall sample (N = 1,675) was randomly divided to provide a replication of the factor analysis. Using the two separate samples and the combined, total sample, one seven-factor solution and two eight-factor solutions emerged. All factors met conventional standards for internal consistency, with the exception of one factor consisting of only three items. The results of this study suggest that the factor structure of the Anorexia Bulimia Inventory closely parallels the intuitively designed subscales. All nine subscales emerged as separate, interpretable factors in at least one sample. Four subscales were clearly corroborated by the factor analysis, suggesting that these factors represent stable constructs that are relevant to populations at-risk for the development of eating disorders. The factor analyses provided moderate corroboration of four other subscales. Although these four factors did show deviations across samples, they all emerged as interpretable factors, suggesting that the constructs likely reflect some of the prominent ideational and behavioral issues relevant to at-risk populations. Finally, one subscale emerged as an interpretable factor in only one sample. This failure to replicate across samples may reflect problems in the wording or choice of items included on the subscale, or it could indicate that these issues are less relevant for at-risk populations. The results of this study, together with the existing evidence of the measure\u27s psychometric properties, support the use of the Anorexia Bulimia Inventory in the assessment of eating disorders

Eating Disorder Risk Factors: A Prospective Analysis

The current study examined whether elevations on four variables (drive for thinness, depressed mood, maladaptive cognitions, and ineffectiveness) were related to increased risk of developing an eating disorder over a 4-year prospective interval. Subjects (N = 191) were female undergraduates who were assessed with the Anorexia-Bulimia Inventory (ABI), Eating Disorder Inventory (EDI), and a structured clinical interview. Results indicated that individuals with elevated scores on each of the four variables at the initial assessment did not show higher absolute eating disorder incidence rates over the 4-year interval. However, initial scores on the four variables together lll explained approximately 13% of both anorexia and bulimia symptom severity variance at the final assessment. Changes over time in the four variables were more highly related to later symptom severity, explaining 34% of the variance in anorexic severity and 16% in bulimic severity. Thus, the findings suggest that initial scores, and especially changes in scores, on the four variables were related to severity of symptoms 4 years later. However, a large proportion of the variance in eating disorder severity remained unexplained. Examination of the role of each risk variable individually revealed that initial elevations on maladaptive cognitions and drive for thinness subscales were related to higher anorexic symptom severity at the later assessment. Of interest was the absence of significant relationships between early scores on maladaptive cognitions and drive for thinness and subsequent bulimic symptoms, suggesting that anorexia and bulimia may have somewhat different risk pathways. The pretest scores on the depressed mood and ineffectiveness subscales were not significantly correlated with symptom severity at the later assessment, and were not identified by the regression analyses as parsimonious or efficient predictors of eating disorder symptoms. This finding suggests that perhaps early difficulties with depression and low self-esteem are less related to onset of later eating disorders than previously believed. Finally, the overall 4-year incidence rate of .6% found in the current study suggests that as women move through their college years, they are departing the developmental period of high risk for onset of eating disorders, and thus, new cases become increasingly rare

CD1a expression in psoriatic skin following treatment with propylthiouracil, an antithyroid thioureylene

BACKGROUND: The antithyroid thioureylenes, propylthiouracil (PTU) and methimazole (MMI), are effective in the treatment of patients with plaque psoriasis. The mechanism of action of the drugs in psoriasis is unknown. Since the drugs reduce circulating IL-12 levels in patients with Graves' hyperthyroidism, the effect of propylthiouracil on CD1a expression in psoriatic lesions was examined in biopsy samples of patients with plaque psoriasis. CD1a is a marker of differentiated skin antigen presenting cells (APC, Langerhans cells). Langerhans cells and skin monocyte/macrophages are the source of IL-12, a key cytokine involved in the events that lead to formation of the psoriatic plaque. METHODS: Biopsy specimens were obtained from six patients with plaque psoriasis who were treated with 300 mg propylthiouracil (PTU) daily for three months. Clinical response to PTU as assessed by PASI scores, histological changes after treatment, and CD1a expression in lesional skin before and after treatment were studied. RESULTS: Despite significant improvement in clinical and histological parameters the expression of CD1a staining cells in the epidermis did not decline with propylthiouracil treatment. CONCLUSIONS: It appears that the beneficial effect of propylthiouracil in psoriasis is mediated by mechanisms other than by depletion of skin antigen-presenting cells

Glutathione and Adaptive Immune Responses against Mycobacterium tuberculosis Infection in Healthy and HIV Infected Individuals

Glutathione (GSH), a tripeptide antioxidant, is essential for cellular homeostasis and plays a vital role in diverse cellular functions. Individuals who are infected with Human immuno deficiency virus (HIV) are known to be susceptible to Mycobacterium tuberculosis (M. tb) infection. We report that by enhancing GSH levels, T-cells are able to inhibit the growth of M. tb inside macrophages. In addition, those GSH-replenished T cell cultures produced increased levels of Interleukin-2 (IL-2), Interleukin-12 (IL-12), and Interferon-gamma (IFN-γ), cytokines, which are known to be crucial for the control of intracellular pathogens. Our study reveals that T lymphocytes that are derived from HIV infected individuals are deficient in GSH, and that this deficiency correlates with decreased levels of Th1 cytokines and enhanced growth of M. tb inside human macrophages

Delineation of the influence of propionylcarnitine on the accumulation of long-chain acylcarnitines and electrophysiologic derangements evoked by hypoxia in canine myocardium

To investigate the potential influence on one analogue of carnitine on the electrophysiologic derangements elicited by myocardial ischemia and subsequent reperfusion, we evaluated whether increasing concentrations of propionylcarnitine would interact with carnitine acyltransferase I and thereby decrease the accumulation of long-chain acylcarnitines during hypoxia in isolated adult canine myocytes. Propionylcarnitine (1-100 microM) did not alter the sixfold reversible increase in long-chain acylcarnitines elicited by 10 minutes of hypoxia. Likewise, propionylcarnitine did not alter the reversal of the accumulation of long-chain acylcarnitines associated with reoxygenation of hypoxic myocytes. To assess whether analogues of carnitine could influence the development or reversal of the electrophysiologic derangements induced by hypoxia in adult canine epicardial tissue, selected concentrations of propionylcarnitine (1 microM to 10 mM) were administered prior to and during 15 minutes of hypoxic perfusion at 35 degrees C followed by 5-20 minutes of reoxygenation. Continuous intracellular transmembrane action potentials were recorded with glass microelectrodes. Administration of propionylcarnitine prior to and during hypoxia did not alter the electrophysiologic derangements elicited by hypoxia or subsequent reoxygenation. Therefore, propionylcarnitine does not influence the activity of carnitine acyltransferase I and does not alter the accumulation of long-chain acylcarnitines during hypoxia. Although propionylcarnitine may protect ischemic myocardium by enhancing the recovery of contractile function during reperfusion, propionylcarnitine does not attenuate any of the electrophysiologic alterations observed during hypoxia or subsequent reoxygenation in isolated tissue

Body image and tobacco cessation: relationships with weight concerns and intention to resume tobacco use

Concern about weight gain after tobacco cessation is a potential barrier to quitting tobacco. Few studies, however, have examined the role of body image in cessation-related weight concerns and anticipated relapse. This study investigated relationships between current body image dissatisfaction, anticipated body image dissatisfaction (discrepancy between anticipated post-cessation body shape and desired body shape), cessation-related weight concerns, and intention to resume tobacco with weight gain. Body image dissatisfaction was significantly related to cessation-related weight concerns. Participants who reported current dissatisfaction with their body image were 2.6 times more likely to intend to resume tobacco use with cessation-related weight gain than those with no body image dissatisfaction. Individuals with anticipated body image dissatisfaction were 3.4 times more likely to intend to resume tobacco compared to individuals with no anticipated body image dissatisfaction. Women and normal weight individuals with anticipated body image dissatisfaction appear to be at particularly high risk for intending to relapse. Results suggest that tobacco cessation interventions may need to target concerns about body image as well as weight gain

Evaluation of a Collaborative Mental Health Program in Primary Care: Effects on Patient Distress and Health Care Utilization

Background: The effectiveness of a collaborative model of mental health treatment under conditions of routine care in a primary care setting has received limited evaluation. Potential effects include reduced symptoms and decreased healthcare utilization. Methods: The present study describes treatment outcome for 234 patients seen by a mental health professional in a primary care clinic using a collaborative model of care. Patients were seen for one session (n = 120), two sessions (n = 59), three sessions (n = 29), or four or more sessions (n = 26). Patients completed the Outcome Questionnaire-45 (OQ-45) at every session. Results: OQ-45 total scores for patients seen for more than one appointment showed statistically significant reductions in psychological distress from first to last session for all groups. Pre-treatment health care utilization was unrelated to level of psychological distress at the first session. A comparison of health care utilization for the six month period before and after the first session showed a small but statistically significant increase in total number of medical visits. Conclusions: The results support the effectiveness of a collaborative model of mental health care for reducing symptoms in patients seen in a primary care setting. Patient\u27s overall healthcare utilization in the short term was largely unaffected