CHILD & ADOLESCENT
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Eating Disorder Research: Klarman Eating Disorder Center
Abstracts to be presented as posters at the Annual Association of Behavior and Cognitive Therapies in Philadelphia, PA, November 2007
Behavioral Manifestations of Body Image Disturbance: Body Checking and Avoidance Among Patients in Residential Treatment for Eating Disorders
Sherrie S. Delinsky, Ph.D., William H. Fagley, M.Ed., Sarah A. St. Germain, B.S., Katherine Ellison, B.A., Anne E. Becker, M.D., PhD., and Philip Levendusky, Ph.D., McLean Hospital, Massachusetts General Hospital
Background: Body image disturbance is a significant risk factor for the development and persistence of eating disorders. Body checking and avoidance, the behavioral manifestations of overvaluation of weight and shape, may be important aspects of eating disorder pathology. Objectives: (1) to describe body checking and avoidance among residential patients; (2) to examine the relation of body checking and avoidance to other patient factors; and (3) to describe change in body checking and avoidance occurring over the course of treatment, given that specific interventions were delivered in Body Image therapy groups to address these behaviors. Methods: To date, 54 residential patients with AN, BN, and EDNOS were assessed at intake using the Body Checking Questionnaire (BCQ), Body Image Avoidance Questionnaire (BIAQ), SCID, EDE-Q, and other measures, and were reassessed at two weeks, four weeks, and at discharge (mean length of stay was seven weeks). Patients' mean age was 18.73 (SD = 1.97) and mean age of onset was 14.86 (SD = 2.51). Mean expected body weight was 78.51% (SD = 5.98) for AN, 107.08% (SD = 17.66) for BN, and 108.99% (SD = 17.31) for EDNOS. Results: Residential patients displayed high levels of body checking and avoidance. There were no differences in body checking or avoidance across diagnostic category and body checking and avoidance were not correlated with percent of expected body weight. Body checking was significantly positively correlated with BDI score (r = .58, p = .000) and number of previous eating disorder medical hospitalizations (r = .36, p = .017) and negatively correlated with age of onset (r = -.58, p = .000) and age of first psychological treatment (-.36, p = .027). Body avoidance was significantly positively correlated with BDI score (r = .56, p = .000). Body checking was significantly correlated with all four EDE-Q subscales, whereas body avoidance was correlated with EDE-Q weight concern, shape concern, and eating concern. Finally, both checking (t = 2.28 (15), p = .038) and avoidance (t = 2.57 (15), p = .022) were significantly reduced at discharge, compared to intake. Discussion: Body checking and avoidance appear to be associated with severity of illness (as indicated by age of onset, treatment history, EDE-Q scores, and BDI), but not associated with diagnostic category or percent of expected body weight. Body checking and avoidance seem amenable to treatment, as significant reductions were observed at discharge in this sample.
McLean Hospital Research
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| 03/06/2006 | Binge Eating Disorder May Have Genetic Ties, McLean Study Finds |