Eating disorders (ED's) are the deadliest of all mental disorders, yet there is a paucity of research examining the clinical presentation of eating disorders in Hispanic populations and limited guidelines for culturally sensitive treatment. Given the rapid growth of Hispanic communities in the U.S., it is important to acknowledge the unique clinical profile of patients within this demographic and examine eating pathology within this socio-cultural context. This case study aims to illustrate the utility, relevance, and effectiveness of cognitive behavioral therapy (CBT) on alleviating eating disorder symptoms in an adult Latina patient with bulimia nervosa to understand the broader implications of applying manualized treatments to diverse populations. We outline the strengths of CBT in quickly modifying problematic thought patterns and decreasing pathological behaviors while raising questions about cultural generalizability. In addition, we explore CBT's limitations in addressing certain underlying ED pathology-driving and maintaining factors for minority individuals. K E Y W O R D S bulimia nervosa, cognitive behavioral therapy, eating disorders, Hispanic, interpersonal psychotherapy, psychodynamic psychotherapy 1 | INTRODUCTION Eating disorders (EDs) are associated with high medical and psychiatric comorbidity, poor quality of life, and increased mortality. They are considered the deadliest of all mental disorders and are the 12th leading cause of disability in women from high-income nations (Hoek, 2016). While there have been considerable advancements in the treatment of ED's, there still remains a significant gap in the literature regarding the conceptualization and treatment of this disease in minority populations. Our primary knowledge of eating pathology and its related clinical considerations have been constrained by research that uses predominantly Caucasian female samples, and little is known about the generalizability of existing evidence-based interventions. Thus, providers are tasked with the challenge of adapting evidence-based programs that demonstrate a nuanced understanding of culturally salient factors, while still maintaining overall program efficacy. A recent review by Galmiche, Déchelotte, Lambert, and Tavolacci (2019) examined studies with reported ED prevalence with various populations and different methods of classification between the years 2000 and 2018. This study adopted illness classifications from both the Diagnostic and Statistical Manual (DSM)-IV and DSM-5 andre-conceptualized overall ED prevalence to encompass both systems of classification. Among the 33 selected studies, the weighted means of lifetime eating disorder prevalence were 8.4% for women and 2.2% for men. For individuals with anorexia nervosa (AN), the weighted means of lifetime prevalence for women and men were 1.4% and 0.2%, respectively. When examining the prevalence of bulimia nervosa (BN), this study found that the weighted means were 1.9% for women and 0.6% for men. For women and men with binge eating disorder (BED...
Developing culturally appropriate obesity prevention programs for African American (AA) adolescent girls that account for psychological risk factors is paramount to addressing health disparities. The current study was part of an investigation utilizing a community-based participatory research framework to gather qualitative data from urban AA girls, their caregivers, and community health liaisons to develop a novel obesity prevention program based on interpersonal psychotherapy for the prevention of excessive weight gain (IPT-WG). In the current study with urban AAs, data from seven focus groups (total sample size, N = 40) were analyzed using thematic analysis. Participants identified problematic eating behaviors, including binge or loss of control eating; highlighted the importance of interpersonal relationships, mood functioning, and eating; and supported the tenets of IPT-WG. While features of IPT-WG generally resonated with participants, culturally based modifications were suggested. These data will be used to inform the development of a culturally relevant IPT-WG program.
Eating disorders are associated with high rates of comorbidity, extreme medical complications, and decreased quality of life, and have the highest mortality rate of any mental illness. Treatment outcomes, however, remain concerningly dire and there is a lack of research examining the effectiveness of factors like therapeutic rapport that have yielded positive outcomes in other patient populations. This article focuses on the potential benefits of therapist self‐disclosure about past lived experiences of eating disorder with individuals struggling with the disease. It examines existing models of treatment in which disclosure‐fueled rapport is harnessed and draws from the personal experience of the author as an eating disorder survivor and practitioner. Research evidence and theoretical rationale from a psychodynamic perspective are used to support the argument for increasing the practice of therapist disclosure about lived eating disorder experience with this patient population.
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