The development and validation of a thirty item, Likert-type scale designed to measure medical students' attitudes to psychiatry-the ATP-30 (Attitudes Toward Psychiatry-30 items)-are described. We had hoped to demonstrate that 'attitude to psychiatry' was not a unitary matter but an amalgam of attitudes to a number of things to do with psychiatric practice. This hope was not fulfilled, as a unitary dimension was obtained. A positive change in the attitudes of students toward psychiatry was demonstrated in third and fourth medical year students in relation to exposure to psychiatry. Such a change was not demonstrable in two classes of occupational therapy students exposed to a course in psychiatry. The reasons for this difference between medical students and occupational therapy students are discussed-there possibly being important implications here for psychiatric curriculum planning in medical school. Lastly, we have demonstrated that the positive change in attitudes amongst medical students was transient rather than lasting-a matter which most studies of attitude change do not address. In spite of the apparent impermanence of the positive change in attitudes among medical students, there are a number of possible used to a scale such as the ATP-30, and these are discussed.

To determine whether peptide YY (PYY), ghrelin, glucose-dependent insulinotropic polypeptide (GIP), and satiety responses to food intake are impaired in anorexia or obesity, we studied 30 female adolescents with anorexia nervosa [body mass index (BMI) 16.3 kg/m2], obesity (BMI 34.3 kg/m2), or normal weight (BMI 20.2 kg/m2). PYY, ghrelin, GIP, insulin, and glucose concentrations and four markers of satiety were measured for 240 min after a mixed meal. The area under the curve for glucose was similar in obese (OB) and normal-weight control (C) subjects but was 15% lower in anorexic (AN) subjects. The area under the curve for insulin was 47% lower in AN and 87% higher in OB subjects, compared with C subjects. After the meal, PYY increased significantly in C (+41%, P < 0.05) but not in AN or OB adolescents. Ghrelin concentrations were highest in AN subjects and lowest in the OB group, compared with C subjects and fell significantly by 25% in all three groups. GIP concentrations were lower in AN subjects throughout the test and increased in all three groups after the mixed meal. AN adolescents reported being less hungry than OB and C adolescents. There was a negative correlation between fasting ghrelin (but not PYY or GIP) and BMI and insulin (r2= 0.33) and a positive correlation between the decrease in hunger 15 min after the meal and PYY concentrations at 15 min (r2= 0.20). In conclusion, the blunted PYY response to a meal in OB adolescents suggests that PYY plays a role in the pathophysiology of obesity. Ghrelin is unlikely to play a causal role in anorexia nervosa or obesity. The lower GIP observed in AN subjects despite a similar caloric intake may appropriately prevent an excessive insulin response in these patients.

Senior psychiatry residents hold attitudes toward persons with intellectual disabilities that are not entirely consistent with the community living philosophic paradigm. More research is needed to uncover how attitudes of psychiatrists develop, as well as how training can influence attitudes.

Fifty-eight women with anorexia or bulimia nervosa were compared with 24 normal women on measures of defense style and parental bonding. Results indicated that all eating-disorder subtypes exhibit more primitive defenses and fewer mature ones than controls. Eating-disorder patients uniformly recalled less paternal empathy than controls. Thus, difficulties involving object representations of fathers may be a theme common to eating disorders. No major differences were identified among eating-disorder subtypes, suggesting that these disorders share substantial psychodynamic features. Patterns of parental bonding were associated with defense styles in a manner consistent with theories that link defense style development to early object relationships.Recent findings suggest a substantial "interface" between eating and personality disorders. Many studies have found eating-disorder (ED) patients who binge and purge (whether they be anorexic or normal in weight) to exhibit "borderline" personality traits: among them mood lability, self-destructiveness, and other impulse-dysregulation problems. Conversely, anorexic patients who solely restrict food intake (without binging) tend to be overcontrolled or "ob-

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Although cases of anorexia nervosa and bulimia are being seen increasingly by health care professionals, little data is available on the prevalence of these disorders in the general population of school age children. Using a validated eating attitude test (EAT), a total of 5150 students, aged 12–20, from public schools and one university in the Province of Manitoba were surveyed. Overall, 5% of males and 22% of females scored 30 or above on the scale, suggesting significant concerns and attitudes regarding eating. These concerns were somewhat higher in urban versus rural settings and seemed to increase between the ages of 12 and 13 and remain high thereafter. Many of the students who scored high on the EAT were overweight, suggesting that these attitudes or concerns are not specific to anorexia nervosa and/or bulimia.

The Eating Attitudes Test (EAT-26) is one of the most frequently used screening questionnaires for anorexia and bulimia nervosa for use with clinical and general populations. Although the psychometric qualities of the instrument have been reported for the English version, little has been done to date to validate a French version. A french version of the EAT-26 was distributed to anglophone students and francophone students, as well as anglophone and francophone patients. Overall, the results demonstrated that the authors' French version has the same psychometric characteristics as the English version when used with clinical and non clinical populations. The overall test and its subscales differentiated between patients and non patients similarly in both linguistic groups. The internal consistency of the two versions, as assessed by Cronbach's alpha, was comparable. Among female high-school students, 14.1% of the anglophone students and 14.3% of the francophone students scored above the cutoff score for significant eating disorders behaviour.

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