Research @ Redleaf
At Redleaf we are actively committed to being involved in conducting research to deepen our understanding of the eating disorders. This age will outline both publications that have come out of The Redleaf Practice as well as describe our ongoing research projects.
current studies.
Stigmatisation of eating disorders.
Stigmatisation of eating disorders is damaging in that it discourages people from seeking treatment for otherwise treatable conditions. Researchers at the University of Sydney are seeking volunteers for a 15-20 minute online study about stigma toward people with eating disorders. The aim of the project is to better inform academics, clinicians and the general public about the types of stigma that people with eating disorders face. Ultimately, an improved understanding of stigma will reduce the considerable burden on people with eating disorders, and hopefully encourage treatment seeking amongst people who are fearful of anxious about being stigmatised.
To take part in the study, you must a) be currently diagnosed with an eating disorder, b) be in recovery from an eating disorder, or c) suspect that you might have an eating disorder. You must be at least 16 years old to participate.
The survey asks questions about your personal experiences with stigma. Specifically, you will be asked about what types of stigmatising attitudes and beliefs you encounter most frequently, and which attitudes and beliefs you find most damaging. In addition, you will also be asked about your psychiatric history and be asked a limited number of demographic questions. Other questions relate to your beliefs about seeking eating disorder treatment and your eating behaviour.
After completing the study, you will be shown a summary page of stigma in eating disorders that outlines the major goals of the study. Resources for further reading are also provided.
The study is being conducted by Scott Griffiths, PhD candidate, and Professor Stephen Touyz, at the University of Sydney, Australia. They can be contacted by emailing sgri6476@uni.sydney.edu.au (Scott) or stephen.touyz@sydney.edu.au (Stephen). The study has been approved by the Human Research and Ethics Committee of the University of Sydney (protocol number 2013/760)
To take part in the study, you must a) be currently diagnosed with an eating disorder, b) be in recovery from an eating disorder, or c) suspect that you might have an eating disorder. You must be at least 16 years old to participate.
The survey asks questions about your personal experiences with stigma. Specifically, you will be asked about what types of stigmatising attitudes and beliefs you encounter most frequently, and which attitudes and beliefs you find most damaging. In addition, you will also be asked about your psychiatric history and be asked a limited number of demographic questions. Other questions relate to your beliefs about seeking eating disorder treatment and your eating behaviour.
After completing the study, you will be shown a summary page of stigma in eating disorders that outlines the major goals of the study. Resources for further reading are also provided.
The study is being conducted by Scott Griffiths, PhD candidate, and Professor Stephen Touyz, at the University of Sydney, Australia. They can be contacted by emailing sgri6476@uni.sydney.edu.au (Scott) or stephen.touyz@sydney.edu.au (Stephen). The study has been approved by the Human Research and Ethics Committee of the University of Sydney (protocol number 2013/760)
Papers from redleaf
collegial alliance in fbt.
A new paper by Murray, Giffiths and le Grange looks at the importance of the role of Collegial Alliance in outcome for FBT. Click here for the paper
ABSTRACT ObjectiveIn keeping with broader efforts to identify mediators and moderators of treatment outcome in anorexia nervosa, this pilot study investigated the association between collegial alliance, which refers to the perceived alliance between case-involved professionals, and treatment outcomes in adolescent patients undergoing family-based treatment (FBT) for anorexia nervosa.
MethodThe self-reported collegial alliance scores of five FBT practitioners were collected, alongside weight- and cognitive-related outcomes for 29 consecutive cases of adolescent anorexia nervosa under their care.
ResultsCollegial alliance discriminated between patients who dropped out of treatment and patients who completed treatment, t(27) = 3.68, p = .001, η2 = .33. Furthermore, there was a strong negative correlation between collegial alliance scores early on in treatment and disordered eating symptoms later in treatment, r(23) = −.67, p < .001. Moderate but non-significant associations were observed between early collegial alliance and patient's percentage of expected body weight later in treatment, r(23) = .32, p = .13.
DiscussionThese findings have important implications for the augmentation of FBT, suggesting that unity amongst clinicians promotes positive treatment outcomes, particularly with regard to disordered eating symptomatology. © 2013 Wiley Periodicals, Inc. (Int J Eat Disord 2013)
ABSTRACT ObjectiveIn keeping with broader efforts to identify mediators and moderators of treatment outcome in anorexia nervosa, this pilot study investigated the association between collegial alliance, which refers to the perceived alliance between case-involved professionals, and treatment outcomes in adolescent patients undergoing family-based treatment (FBT) for anorexia nervosa.
MethodThe self-reported collegial alliance scores of five FBT practitioners were collected, alongside weight- and cognitive-related outcomes for 29 consecutive cases of adolescent anorexia nervosa under their care.
ResultsCollegial alliance discriminated between patients who dropped out of treatment and patients who completed treatment, t(27) = 3.68, p = .001, η2 = .33. Furthermore, there was a strong negative correlation between collegial alliance scores early on in treatment and disordered eating symptoms later in treatment, r(23) = −.67, p < .001. Moderate but non-significant associations were observed between early collegial alliance and patient's percentage of expected body weight later in treatment, r(23) = .32, p = .13.
DiscussionThese findings have important implications for the augmentation of FBT, suggesting that unity amongst clinicians promotes positive treatment outcomes, particularly with regard to disordered eating symptomatology. © 2013 Wiley Periodicals, Inc. (Int J Eat Disord 2013)
Indexing Psychopathology throughout family based treatment for adolescent anorexia nervosa: are we on track?
To view this paper, published in Advances in Eating Disorders: Theory, Treatment and Research click here
The use of effective treatments: the case of an adolescent girl with anorexia nervosa in the context of conversion disorder
Goldstein, M., Madden, S., & Peters, L. (2013) Clin Child Psychol Psychiatry. 2013 Apr;18(2):214-23. doi: 10.1177/1359104512447313. Epub 2012 Jun 13.
The use of empirically supported treatment (EST) has been shown to enhance treatment outcome. The purpose of this case study was to suggest that ESTs further encourage effective reconceptualisation and the ongoing delivery of effective treatment, especially in the case of complex or atypical presentations or response to treatment. This report describes the case of an adolescent girl who underwent Maudsley family-based treatment for anorexia nervosa (AN) for a period of 12 months. Atypical response lead to an understanding of her presentation as representing a primary conversion disorder, within which AN symptoms were conceptualised as another somatic conversion of emotional distress. The report details her clinical presentation and management over the course of her illness. The case offers an important opportunity to explore the central role of the use of ESTs in guiding effective treatment delivery.
Click here for link
Goldstein, M., Madden, S., & Peters, L. (2013) Clin Child Psychol Psychiatry. 2013 Apr;18(2):214-23. doi: 10.1177/1359104512447313. Epub 2012 Jun 13.
The use of empirically supported treatment (EST) has been shown to enhance treatment outcome. The purpose of this case study was to suggest that ESTs further encourage effective reconceptualisation and the ongoing delivery of effective treatment, especially in the case of complex or atypical presentations or response to treatment. This report describes the case of an adolescent girl who underwent Maudsley family-based treatment for anorexia nervosa (AN) for a period of 12 months. Atypical response lead to an understanding of her presentation as representing a primary conversion disorder, within which AN symptoms were conceptualised as another somatic conversion of emotional distress. The report details her clinical presentation and management over the course of her illness. The case offers an important opportunity to explore the central role of the use of ESTs in guiding effective treatment delivery.
Click here for link
The effectiveness of a day program for the treatment of adolescent anorexia nervosa.
Goldstein, M, et al (2010) International Journal of Eating Disorders, 44, 29-38
Abstract:The risks of anorexia nervosa (AN) are well established. Despite its severity, little certainty exists for practitioners, with ethical and financial limitations yielding few controlled studies establishing effective treatments. Thus, other methods of establishing treatment effectiveness are necessary. This study presents preliminary results of an open clinical trial of a day program for adolescents with AN.
Method:Participants were 26 anorectic females, 12–18 years, who completed the “Transition Program.”
Results:Significant change emerged on measures of weight gain, and behavioral and attitudinal measures of eating pathology. Large effect sizes were evident for weight gain at 6 month follow-up. Preliminary trends suggest that treatment gains on these and other measures of eating pathology were maintained at 6 month follow-up.
Discussion:Preliminary results support day program treatment for adolescents with mild-moderately severe eating disorders. Present outcomes are discussed with respect to the dearth of efficacious treatment options for adolescents. © 2010 by Wiley Periodicals, Inc. (Int J Eat Disord 2011; 44:29–38)
To see the article click here
Goldstein, M, et al (2010) International Journal of Eating Disorders, 44, 29-38
Abstract:The risks of anorexia nervosa (AN) are well established. Despite its severity, little certainty exists for practitioners, with ethical and financial limitations yielding few controlled studies establishing effective treatments. Thus, other methods of establishing treatment effectiveness are necessary. This study presents preliminary results of an open clinical trial of a day program for adolescents with AN.
Method:Participants were 26 anorectic females, 12–18 years, who completed the “Transition Program.”
Results:Significant change emerged on measures of weight gain, and behavioral and attitudinal measures of eating pathology. Large effect sizes were evident for weight gain at 6 month follow-up. Preliminary trends suggest that treatment gains on these and other measures of eating pathology were maintained at 6 month follow-up.
Discussion:Preliminary results support day program treatment for adolescents with mild-moderately severe eating disorders. Present outcomes are discussed with respect to the dearth of efficacious treatment options for adolescents. © 2010 by Wiley Periodicals, Inc. (Int J Eat Disord 2011; 44:29–38)
To see the article click here
Disordered eating and the muscular ideal
Masculinity and femininity in the divergence of male body image concerns
Stuart B Murray, Elizabeth Rieger, Lisa Karlov and Stephen W Touyz
Journal of Eating Disorders 2013, 1:11
Background: Given recent assertions suggesting that gender role endorsement may be relevant in the divergence of male body image concerns, this study examined the self-reported gender role endorsement in opposing dimensional extremes of male body image disorders, namely, muscle dysmorphia and anorexia nervosa. This study further examined the relationship between gender role endorsement and eating disordered and muscle dysmorphia disorder pathology.
Methodology: Participants were 21 male muscle dysmorphia patients, 24 male anorexia nervosa patients, and 30 male gym-using controls from Australia, the United Kingdom, and the United States. All participants completed multidimensional measures of masculinity and femininity, and measures of eating disorder and muscle dysmorphia symptomatology.
Results: Patients with muscle dysmorphia reported significantly elevated adherence to masculine (but not feminine) norms relative to control gym-using men and men with anorexia nervosa, whereas patients with anorexia nervosa exhibited elevated feminine (but not masculine) gender role endorsement relative to control gym-using men and men with muscle dysmorphia.
Conclusions: Masculine and feminine gender role endorsement appear to be associated with the divergence of body image concerns towards muscularity and thinness-oriented ideals respectively.
http://www.jeatdisord.com/content/1/1/11
Methodology: Participants were 21 male muscle dysmorphia patients, 24 male anorexia nervosa patients, and 30 male gym-using controls from Australia, the United Kingdom, and the United States. All participants completed multidimensional measures of masculinity and femininity, and measures of eating disorder and muscle dysmorphia symptomatology.
Results: Patients with muscle dysmorphia reported significantly elevated adherence to masculine (but not feminine) norms relative to control gym-using men and men with anorexia nervosa, whereas patients with anorexia nervosa exhibited elevated feminine (but not masculine) gender role endorsement relative to control gym-using men and men with muscle dysmorphia.
Conclusions: Masculine and feminine gender role endorsement appear to be associated with the divergence of body image concerns towards muscularity and thinness-oriented ideals respectively.
http://www.jeatdisord.com/content/1/1/11
