Compared with family therapy, CBT guided self-care has the slight advantage of offering a more rapid reduction of bingeing, lower cost, and greater acceptability for adolescents with bulimia or eating disorder not otherwise specified.
The paper introduces the construction and scoring principles of the Short Evaluation of Eating Disorders (SEED), which was developed for the assessment of the key eating disorders symptoms. The questionnaire uses six items and allows the calculation of two severity indices for anorexia and bulimia nervosa symptoms. Data from two patient and one non-patient sample as well as therapist ratings are used to investigate different validity aspects of the SEED. Overall, the analyses underline the validity of the instrument. Recommendations for future research activities on the SEED are outlined.
Further research is recommended to explore how the needs expressed by carers may best be translated into services that effectively meet the requirements of both patients and carers and reduce the risk to carers' mental health.
Objective: To date no trial has focused on the treatment of adolescents with bulimia nervosa. The aim of this study was to compare the efficacy and cost-effectiveness of family therapy and cognitive behavior therapy (CBT) guided self-care in adolescents with bulimia nervosa or eating disorder not otherwise specified. Method: Eighty-five adolescents with bulimia nervosa or eating disorder not otherwise specified were recruited from eating disorder services in the United Kingdom. Participants were randomly assigned to family therapy for bulimia nervosa or individual CBT guided self-care supported by a health professional. The primary outcome measures were abstinence from binge-eating and vomiting, as assessed by interview at end of treatment (6 months) and again at 12 months. Secondary outcome measures included other bulimic symptoms and cost of care. Received 1-3 sessions of family therapy (N=4) Received intervention (i.e., attended ≥4 sessions) (N=29) Assigned to guided self-care (N=44): Did not take up treatment (N=6) Received 1-3 sessions of family therapy (N=7) Received intervention (i.e., attended ≥4 sessions) (N=31) Included in analysis (N=41)
These preliminary findings, although in need of replication with a larger sample and limited by the attrition rate in some of the self-report measures, indicate that patients who did not involve their parents in treatment may perceive their mothers as having a more blaming and negative attitude towards the patient's illness. Public awareness about BN needs to be raised, focusing on reducing the stigma and negative views attached to this illness.
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