IntroductionStructural Analysis of Social Behaviour by L.S. Benjamin as revised by Scilligo represents self image by two axes: affiliation with love and hate as extreme points; interdependence with freedom and control as extreme points. Axes define a circumplex with 4 quadrants: loving freedom; hostile freedom; hostile control, loving control. Psychic wellness consists of high loving control and freedom and low hostile control and freedom. Quadrants are divided into 12 clusters: self-emancipation, self-affirmation, self-exploration, self-acceptance, self-protection, self-regulation, self-limitation, self-blame, self-attack, self-rejection, self-neglect, self-isolation.ObjectiveThe present study aims to enrich knowledge about intrapsychic world of people with Eating Disorders by analyzing self image of diagnostic subtypes.AimsDifferentiating diagnostic subtypes self image in order to have a new key to choose therapeutic interventions.Methods250 women with ED, outpatients of the ED Unit of an Italian General Hospital, were administered the Intrex questionnaire, the operational definition of the 12 clusters. One-way ANOVA and post-hoc comparisons between diagnostic subtypes were performed.ResultsResults indicate that ED patients have negative self-image. Bulimics show the highest level of self-blame, self-attack and self-rejection and the lowest of self-affirmation, self-exploration, self-acceptance, self-protection; anorexics show the highest level of self-regulation and self-limitation together with poor self-affirmation, self-exploration, self-acceptance. BED and EDNOS profiles appear less self attacking and more self acceptant.ConclusionsEating disorder diagnostic subtypes seem to have distinct intrapsychic profiles that can be reflected in different interpersonal behaviours. Such knowledge may help the therapist to choose the better interpersonal position to support therapeutic change.
ObjectivesMost of brief instruments of evaluation of substance related disorders focuses on the dependence physical indexes and/or on compulsion, evaluating only incidentally the dependence-related social and psychological factors. Our aim is to create and validate a short questionnaire, easy to be distributed, exploring the dependence social and psychological indexes and to be used to evaluate the effectiveness of the therapeutic and rehabilitation treatments whose aim is to change lifestyle as well as abstinence.MethodsThe S.A.I.D. is an auto-evaluation questionnaire of 39 items that explore emotions, thoughts and behaviours in addictive subjects, thus providing patient's diagnostic profile in two areas: social area, divided into 4 scales (work/study, relationships, social interaction, cure/physical health); psychological area, divided into 5 scales (depression, hostility, lack of attention, anxiety, alexithymia).446 subjects have been examined: 256 with alcohol dependence diagnosis by using DSM-IV-TR, 70 with cocaine dependence diagnosis by using DSM-IV-TR, 120 not clinical subjects representing the control sample, that are not under psychiatric treatments.ResultsThe statistical analysis by Student's t test has showed that the instrument is able to discriminate between alcoholics, cocaine addicts and healthy control subjects; Cronbach's Alpha analysis has noticed a good internal validation in two main areas of the questionnaire, but a substantial unhomogeneity about single subscales.ConclusionsThese results indicate that the instrument is useful for the overall evaluation of social and psychological impairment in addictions, but also suggest the need for a revision of the instrument aiming to a better internal consistency of subscales.
ObjectivesEating Disorders concern a growing number of people. Several instruments were created to assess symptomatology of Anorexia Nervosa and Bulimia Nervosa. Our aim is to create and validate a short questionnaire about all the eating symptoms of Eating Disorders, including Binge Eating Disorder.MethodsThe Questionnaire of Eating Behaviours (Scheda dei Comportamenti Alimentari, SCA) is a self-administered questionnaire composed of 13 items regarding all the eating symptoms of Eating Disorders. Items are divided into 3 scales: Restrictive Eating, Weight Control Practices and Binge Eating. The SCA was given to 200 female outpatients with Eating Disorders and to 218 non-clinical adult women. Student's t test was performed to compare clinical and non-clinical subjects, one-way ANOVA was performed to compare three diagnostic subtypes (Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder). Cronbach's Alpha and factor analysis were used to validate the questionnaire.ResultsClinical and non-clinical subjects get significantly different scores in all the three subscales. Besides, the three diagnostic subtypes scores significantly differ on each scale. Cronbach's Alpha values show a significant inner consistency in the subscales of Restrictive Eating and Binge Eating, while the Weight Control Practices one is not very homogeneous, as expected. The factor analysis has shown the presence of three factors, corresponding to the 3 scales.ConclusionsThe SCA has shown to be effective in distinguishing people with Eating Disorders from non-clinical subjects. For its characteristics of being short, easy to fill in and to interpret, the SCA seems to be an instrument suitable for screening purposes.
IntroductionNon-alcoholic fatty liver disease (NAFLD) is becoming the most common liver disease worldwide. Prolonged fasting and excessive caloric intake are possible nutritional causes of NAFLD incurred by patients with eating disorders (ED).AimsAims of this study are: identifying if eating disorders are associated with NAFLD; evaluating possible improvements of the risk of NAFLD and of psychopathology determined by integrated multidisciplinary treatment (behavioral therapy, dietary assessment and treatment, clinical care overall).Methods78 patients with ED received the integrated multidisciplinary treatment. Psychopathology and eating symptoms were assessed before and after treatment through Eating Disorder Inventory and Questionnaire of Eating Behaviours (QEB). The risk of NAFLD was evaluated by Fatty liver index (FLI) based on values of γGT, BMI, triglycerides and waist circumference.Results54% of patients with binge eating disorder in our sample has a 60-FLI, indicating a risk of NAFLD higher than 85%.FLI (p: 0.003) and yGT (p: 0.006) were significantly lower after treatment, thus indicating an improvement in the risk of NAFLD. Four of the eight EDI's subscales improved: Drive for thinness (p: 0.008), Interoceptive awareness (p < 0.001), Bulimia (p: 0.001), Ineffectiveness (p: 0.014). Two of the three SCA's subscales improved: Binge Eating (p: 0.001) and Food Restriction (p: 0.016).Conclusionsthe association between NAFLD and eating disorders was shown together with the efficacy of the multidisciplinary treatment. The risk index FLI and γGT were reduced by the therapy but should be monitorized over time.
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