Findings support a connection between mentalising and attachment in early adolescence, and further suggest that social cognitive processes may be context and relationship-specific.

This paper reviews the role of childhood family functioning and of sexual and physical abuse in eating disorders. Bearing in mind the huge methodological differences across studies the following tentative conclusions can be reached: there is evidence of more family pathology in eating disorder families than in normal control families. Those with bulimic disorders seem to have poorer family functioning than restrictors. Different eating disorder subgroups show less or comparable levels of family pathology compared to psychiatric or other medical controls depending on the comparison group. In bulimia nervosa high levels of family disturbance seem to be associated with greater severity and chronicity of bulimic symptomatology. There is some suggestion that family functioning may have more of an effect on Axis II than on Axis I disorders. Rates of sexual abuse appear to be higher in bulimia nervosa than in normal controls. Depending on which psychiatric control groups are chosen, eating disorder patients may have similar, higher or lower rates of contact sexual abuse. The majority of studies fails to ®nd differences between eating disorder subtypes in terms of rates of sexual abuse. The evidence on whether there is any link between abuse characteristics and the severity of eating disorder is inconclusive. On balance, childhood sexual abuse does not seem to be a speci®c risk factor for eating disorders. Physical abuse is more common in bulimic than in restricting disorders and usually occurs in the context of a disturbed family environment. The clinical implications of these ®ndings are discussed. Future research in the area of family factors or childhood trauma in eating disorders needs to get away from mere`head

Background: Individuals referred to psychiatric services are often ambivalent about service involvement. Aims: The aim of this study was to assess the impact of a brief motivational intervention during initial consultation with community psychiatric patients. Method: 45 patients referred to a Community Mental Health Team received an initial consultation followed by a feedback letter, both of which drew on the principles of motivational interviewing. These users were compared with matched controls who received a standard psychiatric assessment. The impact of the initial consultation, with or without motivational enhancement, on users' attitudes to their care, motivation to change, compliance and outcome was assessed at one month post-consultation and 3-4 months later. Results: After initial consultation, patients in both groups had similar problem severity ratings. Those patients who had received the intervention were more motivated to change, and had more positive attitudes to their consultation and care. Attitudinal differences tended to persist up to 3-4 months follow-up. Conclusions: A brief motivational intervention has at least short-term effects on motivation, and it improves attitude to care.

Aims and methodLeaflets are commonly used as a way of providing information to users. In this study, we use a simple index of ‘readability’ to compare a range of leaflets available to people with mental health problems.ResultsThe majority of the leaflets contained passages that are likely to be beyond the comprehension of people with mental health problems.Clinical implicationsLeaflets are a cost-effective way of providing information, but only if the text can be understood by the target audience.