Effectiveness of cognitive behavioral therapy supported by virtual reality in the treatment of body image in eating disorders: One year follow-up

Postprint de l’autorBody image disturbance is a significant maintenance and prognosis factor in eating disorders. Hence,existing eating disorder treatments can benefit from direct intervention in patients’ body image. No controlled studies have yet compared eating disorder treatments with and without a treatment component centered on body image. This paper includes a controlled study comparing Cognitive Behavioral Treatment (CBT) for eating disorders with and without a component for body image treatment using Virtual Reality techniques. Thirty-four participants diagnosed with eating disorders were evaluated and treated. The clinical improvement was analyzed from statistical and clinical points of view. Results showed that the patients who received the component for body image treatment improved more than the group without this component. Furthermore, improvement was maintained in post-treatment and at one year follow-up. The results reveal the advantage of including a treatment component addressing body image disturbances in the protocol for general treatment of eating disorders. The implications and limitations of these results are discussed below

Palabras relacionadas con la comida y el cuerpo : un estudio sobre la selección de material estimular con significado para utilizar en tareas experimentales en el área de los trastornos alimentarios

El propósito del presente trabajo se centra en el estudio de un conjunto de palabras relevantes en los trastornos alimentarios con respecto a su carga semántica y otros índices más formales, tales como la frecuencia de uso y familiaridad. Estos datos son imprescindibles para poder elegir otro conjunto de palabras que no tengan relación con esas categorías semánticas, pero con similares características con respecto a los índices antes mencionados, para que puedan ser consideradas apropiadamente como controles. Así, en el Estudio 1, treinta sujetos evaluaron la pertenencia de un conjunto de palabras a las categorías de comida y cuerpo, mientras que en el Estudio 2 se analizó la frecuencia de uso y la familiaridad de las palabras seleccionadas en una muestra de cien sujetos. Igualmente, también se aplicaron estos índices a una serie de vocablos con los mismos trigramas que parte de nuestras palabras de estudio, con el fin de confirmar que éstas no son las de mayor frecuencia en nuestro Idioma, requisito imprescindible para realizar una tarea basada en trigramas. Tener datos acerca de estos índices se convierte en un requisito necesario para poder llevar a cabo tareas experimentales basadas en material estimular con significado. Desgraciadamente en nuestro idioma contamos con muy pocos trabajos que hayan analizado estos temas. Este estudio pretende contribuir a cubrir esta laguna

Intrusiones sobre trastornos alimentarios en población general : desarrollo y validación del inventario de pensamientos intrusos alimentarios (INPIAS)

The purpose of the present study was to develop and validate the Eating-related Intrusive Thoughts Inventory (INPIAS), a self-report that evaluates the frequency of intrusions with an eating-related content, their emotional repercussions and control strategies. Three hundred fifty eight participants from the community took part in this investigation. The principal components analysis of the first part (type and frequency of intrusions) indicated a bi-factorial structure: “Normative discontent intrusions” and “Eating psychopathology impulses”. Part 2A (consequences and ratings) was made up of two factors: “Emotional charge” and “Fulfilled prophesy/personal significance”. Part 2B (control strategies) consisted of four factors: “Normalizing strategies”, “Neutralization/suppression”, “Non-eating rituals” and “No control”. The internal consistency and the test-retest reliability were excellent. The INPIAS was able to differentiate between people with and without risk of suffering an eating disorder, as their intrusions were quantitatively and qualitatively different. The INPIAS is useful evaluating intrusions related to eating disorders, an area that has been studied little and is of increasing interest in the obsessive-compulsive spectrum.El objetivo del presente estudio fue el desarrollo y validación del Inventario de Pensamientos Intrusos Alimentarios (INPIAS), autoinforme que evalúa la frecuencia de intrusiones de contenido alimentario, sus repercusiones emocionales y estrategias de control. Los participantes fueron 358 provinentes de la comunidad. El análisis de componentes principales indicó en la parte primera (tipo/frecuencia intrusiones) una estructura bi-factorial: “Intrusiones de descontento normativo” e “Impulsos de psicopatología alimentaria”. La parte 2A (consecuencias, valoraciones) se compuso de dos factores: “Carga emocional” y “Profecía cumplida/significado personal”, y la parte 2B (estrategias de control) de 4 factores: “Estrategias normalizadoras”, “Neutralización/supresión”, “Rituales no alimentarios” y “No control”. La consistencia interna y fiabilidad test-retest fueron excelentes. El INPIAS diferenció entre personas con y sin riesgo de padecer un trastorno alimentario, siendo sus intrusiones cuantitativamente y cualitativamente distintas. El INPIAS es útil en la evaluación de intrusiones relacionadas con los trastornos alimentarios, un área poco estudiada y de creciente interés en el espectro obsesivo-compulsivo

Obsesividad e intrusiones alimentarias en pacientes con trastornos alimentarios y en lapoblación general

Eating disorders (ED) and obsessive-compulsive disorder (OCD) are different clinical entities, although they share psychopathological elements that have been insuffi ciently investigated. Our objectives are fi rstly to analyze, in patients with ED, relationship between OCD symptoms and cognitive intrusions with eating content, their emotional impact, and strategies for controlling them and, secondly, to examine to what extent OCD symptoms predict these intrusions in patients with ED. In the general population, results showed signifi cant associations between OCD symptoms and frequency of intrusions on physical exercise, emotional consequences, dysfunctional appraisals, and control strategies, which persisted after controlling for age, body mass index, depression, and anxiety. In ED patients, associations with OCD symptoms persisted only for emotional consequences and dysfunctional appraisals. These results indicate that the relationship between both disorders is explained by the importance that patients give to the unpleasant cognitive experiences, rather than by the frequency with which these are experienced.Los trastornos alimentarios (TA) y el trastorno obsesivo-compulsivo (TOC) son entidades clínicas diferenciadas, aunque comparten elementos psicopatológicos comunes poco investigados. Nuestros objetivos son, primero, analizar en población general (n = 100) y personas con TA (n = 84) la relación entre síntomas TOC e intrusiones cognitivas de contenido alimentario, su impacto emocional, y las estrategias para controlarlas; segundo, examinar en qué medida los síntomas TOC predicen esas intrusiones. Los resultados muestran, en población general, asociaciones signifi cativas entre síntomas de TOC y frecuencia de intrusiones sobre ejercicio físico, consecuencias emocionales, valoraciones disfuncionales, y estrategias de control, que se mantienen tras controlar edad, índice de masa corporal, depresión, y ansiedad. En pacientes TA, las asociaciones con síntomas TOC únicamente se mantuvieron con consecuencias emocionales y valoraciones disfuncionales. Los resultados indican que las relaciones entre ambos trastornos se explican por la importancia otorgada a las experiencias cognitivas desagradables, y no tanto a la frecuencia con que las experimentan.

Selective processing of food— and body—related information and autonomie arousal in patients with eating disorders

Both attentional bias (using the modified Stroop Task) and autonomic reactivity (skin conductance level) to food- and body-related information were assessed in 25 patients with eating disorders (15 patients with anorexia, 10 patients with bulimia) amI 18 women controls. Patients with anorexia showed the greatest inrerference in color-naming foodrelated words. However, on this occasion there were no difierences in body condition, probably because of heterogeneity of clinical samples and because the control group were staff members, so the target information was very familiar to them. The groups differed in their autonomic reactivity while performing Ihe Stroop. Ihe patients with anorexia responded wiíh higher 5km conductance (p < .036). The discussion focuses on the differential prohíes shown by samples and on the relationship between cognitive biases and autonomic arousal [email protected]; [email protected]

Prevalencia del trastorno por atracón en una muestra clínica de obesos

Introduction: Binge eating disorder is characterized by the presence of recurrent binge eating episodes in a short period of time, accompanied by loss of control. This disorder is the most frequent of all eating disorders in obese people, both adults and children. Objective: The objective of this study was to obtain prevalence data for binge eating disorder in a sample of obese children, users of a specialized pediatric unit in the treatment of childhood obesity. Material and Methods: A sample had 70 children and adolescents aged 9 to 16, with a mean age of 12 years attending a pediatric ward in the General Hospital of Valencia. To carry out the evaluation the following instruments were used, Diagnostic Interview for Binge Eating Disorder (SCID-IV), Binge Eating Disorder Scale Child (C-BED) and Questionnaire of eating patterns and weight (QEWP). Results: After the assessment, 6% of the clinical sample was diagnosed with binge eating disorder according to criteria established by the DSM-IVTR, and 14% showed subclinical forms of the diagnosis. Conclusions: The results are in line with previous studies that highlight the necessity of assessing these disorders in specialized units in the treatment of obesity

Body image and adolescence: A behavioral impairment model

Adolescence is a period marked by important physical and social changes that can lead to a negative body image. The purpose of this study was to find a model enabling the appearance of behavioral impairment related to body image (restrictions, avoidance, and checking) to be predicted by body image attitudes (concern or Appearance Orientation, and dissatisfaction or Appearance Evaluation), Gender, emotional symptomatology, self-consciousness, ideas of reference (IR) and age. A total of 661 participants (67.47% girls) with an average age of 17.14 years (SD=2.34) filled in the GHQ-28, SCS on self-consciousness, REF referential thinking scale, MBSRQ (AO and AE), and BIAQ. A partial mediation model was found for IR, age and depressive symptomatology between dissatisfaction and concern about body image and Gender, to behavioral impairment related to body image. The results found suggest that age, depressive symptomatology, and IR may be mediator variables in the relationship between dissatisfaction and concern about body image, on body image behavioral impairment. This relationship implies a severity to be considered in intervention and monitoring of body image behavioral impairments in adolescents

Psicopatología y realidad virtual

Virtual Reality (VR) is becoming an important tool in the research on many and various fields. Today, the progresses in the development of this technology are going even faster than we expected, and therefore it is being necessary to think over its potential uses and abuses. This paper focuses in the analysis of some of the applications and implications of VR on Psychopathology. Although we are plenty aware of the broad range capable of being covered, we have focused on: a) VR as a “realistic” lab setting where problematic behaviours, affects, thoughts, etc. could be studied; b) VR as a model to deal with certain core questions which have always been of interest for psychopathologists; and c) VR as experiences open to be labelled as psychopathological. We believe that VR has the potential of becoming the tool that will enable Psychopathology to challenge and to modify theoretical assumptions already established, as well as to help us to find new answers to old questions. VR could also make new questions rise on the psychological and psychopathological horizons, questions not only related to theoretical or empirical issues, but also to moral ones. This line of research has just started. La Realidad Virtual (RV) se está empezando a considerar como una importante herramienta para la investigación en muchos y muy variados campos. Actualmente, los progresos en el desarrollo de esta tecnología están yendo incluso más rápido de lo que podemos anticipar, por lo que reflexionar sobre sus potenciales usos y abusos resulta algo totalmente necesario. Este trabajo se centra en analizar algunas de las aplicaciones e implicaciones que la RV puede tener para la Psicopatología. Obviamente, éstas pueden ser muy diversas, pero aquí nos centramos sólo en tres: a) La RV como un contexto de laboratorio «realista» donde estudiar comportamientos, emociones, pensamientos, etc., problemáticos; b) la RV como un modelo para abordar algunas preguntas centrales, que desde siempre han intrigado a los psicopatólogos; y c) la RV y posibles experiencias ¿psicopatológicas?. Creemos que la RV se puede constituir en una herramienta que permita a la Psicopatología retar y modificar posiciones teóricas establecidas, a la par que plantearse otras nuevas. Esta nueva forma de experiencia, a la vez que puede ayudarnos a encontrar respuestas a viejas preguntas, puede también hacer surgir otras nuevas en el horizonte psicopatológico y psicológico, y no sólo relacionadas con cuestiones teóricas o empíricas, sino también morales. Este camino de investigación no ha hecho más que empezar

La escala de estima corporal (BES): validación de una muestra española

 The purpose of the present study was to validate in Spanish population the Body Esteem Scale (BES), elaborated by Franzoi &amp; Shields (1984). A sample of 288 students from primary, secondary and uni-versity schools (212 women and 72 men), ranged in age between 14 to 29 years, was administered the BES. In this work, psychometric data are presented, as internal consistency, test-retest reliability (1 month), convergent validity and factor analysis. Furthermore, the findings indicate differences in body esteem between men and women, between age groups, BMI (Body Mass Index) groups and between groups according to EAT-40 and Restriction Scale scoresEste trabajo tiene como objetivo validar en población española la Escala de Estima Corporal (BodyEsteem Scale —BES), elaborada por Franzoi y Shields (1984). La escala fue aplicada a una muestra total de 288 participantes (212 mujeres y 72 varones), con un rango de edad entre 14 y 29 años, procedentes de escuelas, institutos y facultades universitarias. En este estudio se ofrecen datos sobre la consistencia interna, estabilidad temporal (1 mes), validez convergente y análisis factorial. Además, se encuentran diferencias en la estima corporal entre varones y mujeres, en función de la edad, del índice de Masa Corporal (IMC), y de las puntuaciones en el EAT-40 y la Escala de Restricción

Analysis of the Effectiveness of Cognitive Remediation and Emotional Skills Training in a Group format. Preliminary results in patients with eating disorders

Eating disorders (ED) are associated with cognitive and emotional impairments. Cognitive and Emotional Remediation Skill Training (CREST) was developed as an intervention program targeting patients' thinking styles and their skills in recognizing and managing emotions. AIM: to analyze the effects of the CREST intervention in a group format in females with ED. METHOD: eight females underwent a CREST program (eight 90-minute sessions) targeting cognitive (central coherence, set shifting, problem solving) and emotional (recognizing emotions, managing emotions) difficulties. It was assessed cognitive flexibility (Wisconsin Card Sorting Test), decision-making (Iowa Gambling Task), central coherence (Group embedded Figures Test), alexithymia (Toronto Alexithymia Scale), affect (Positive and Negative Affect Schedule), ED symptomatology (Eating Attitudes Test). RESULTS: Results showed improvements in cognitive flexibility, decision-making, and central coherence, a decrease in depression, anxiety, negative affect, and alexithymia, and an improvement in quality of life. CONCLUSION: The results of this study on patients with ED suggest that the CREST can reduce ED symptomatology and could increase adherence to psychological treatments