Development of an Eating-Disorder Program

  • David L. Tobin
  • Craig Johnson
  • Kevin Franke

Abstract

Paralleling the rise in incidence of anorexia nervosa and bulimia, there has been a proliferation of programs whose purpose is to provide treatment to patients with eating disorders. These programs present a wide range of treatment philosophies that reflect the diversity of presentation within this patient population. The circumscribed symptom patterns that identify bulimia and anorexia nervosa are often accompanied by a wide spectrum of concomitant symptoms that complicate the clinical picture. Thus, patients must undergo a thorough medical and psychological evaluation, and treatment programs must be prepared to meet a variety of patient needs. The purpose of this chapter is to provide a comprehensive model for treatment programs attempting to accomplish this goal.

Keywords

Obesity Depression Marketing Dexamethasone Rosen 

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References

  1. Adler, G. A. (1985). Borderline psychopathology and its treatment. Northvale, NJ: Jason Aronson.Google Scholar
  2. American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author.Google Scholar
  3. American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed. rev.). Washington, DC: Author.Google Scholar
  4. Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 5, 561–571.CrossRefGoogle Scholar
  5. Brotman, W. W, Herzog, D. G., & Woods, S. W. (1984). Antidepressant treatment of bulimia: The relationship between bingeing and depressive symptomology. Journal of Clinical Psychiatry, 45, 7–9.PubMedGoogle Scholar
  6. Bruch, H. (1973). Eating disorders: Obesity,anorexia nervosa, and the person within. New York: Basic Books.Google Scholar
  7. Casper, R. C., Eckert, E. D., Halmi, K. A., Goldberg, S. C., & Davis, J. M. (1980). Bulimia: Its incidence and clinical importance in patients with anorexia nervosa. Archives of General Psychiatry, 37, 1030–1035.PubMedCrossRefGoogle Scholar
  8. Connors, M. E., Johnson, C. L., & Stuckey, M. K. (1984). Treatment of bulimia with brief psychoeducational group therapy. American Journal of Psychiatry, 141, 1512–1516.PubMedGoogle Scholar
  9. Conte, H. R., Plutchik, R., Karasu, T B., & Jerrett, I. (1980). A self-report borderline scale: Discriminative validity and preliminary norms. Journal of Nervosa and Mental Disease, 168, 428–435.CrossRefGoogle Scholar
  10. Crandall, C. S. (1988). The social contagion of binge eating. Journal of Personality and Social Psychology, 55, 589–599.CrossRefGoogle Scholar
  11. Derogatis, L. R., Rickles, K., & Rock, A. E (1976). The SCL-90 and the MMPI: A step in the validation of a new self-report scale. British Journal of Psychiatry, 128, 280–289.PubMedCrossRefGoogle Scholar
  12. Fairburn, C. G. (1984). Cognitive behavioral treatment for bulimia. In D. M. Garner & P E. Garfinkel (Eds.), Handbook of psychotherapy for anorexia nervosa and bulimia (pp. 160–192). New York: Guilford Press.Google Scholar
  13. Garfinkel, P. E., & Garner, D. M. (1982). Anorexia nervosa: A multidimensional perspective. New York: Brunner! Mazel.Google Scholar
  14. Garfinkel, P E., Moldofsky, H., & Garner, D. M. (1980). The heterogeneity of anorexia nervosa: Bulimia as a distinct subgroup. Archives of General Psychiatry, 37, 1036–1040.PubMedCrossRefGoogle Scholar
  15. Garner, D. M., & Bemis, K. M. (1984). Cognitive therapy for anorexia nervosa. In D. M. Garner & P E. Garfinkel (Eds.), Handbook of psychotherapy for anorexia nervosa and bulimia (pp. 107–146). New York: Guilford Press.Google Scholar
  16. Garner, D. M., Olmstead, M. P, & Polivy, J. (1984). Eating Disorder Inventory Manual. Psychological Assessment Resources.Google Scholar
  17. Garner, D., Garfinkel, P., Schwartz, D., & Thompson, M. (1980). Cultural expectations of thinness in women. Psychological Reports, 47, 483–491.PubMedCrossRefGoogle Scholar
  18. Garner, D. M., Garfinkel, P. E., & Olmstead, M. (1983). An overview of sociocultural factors in the development of anorexia nervosa. In P. L. Darby, R E. Garfinkel, D. M. Garner, & D. V Coscina (Eds.), Anorexia nervosa: Recent developments in research (pp. 65–82). New York: Alan R. Liss.Google Scholar
  19. Garner, D. M., Rockert, W, Olmstead, M. P, Johnson, C, & Coscina, D. V (1984). Psychoeducational principles in the treatment of bulimia and anorexia nervosa. In D. M. Garner & P. E. Garfinkel (Eds.), Handbook of psychotherapy for anorexia nervosa and bulimia (pp. 513–572). New York: Guilford Press.Google Scholar
  20. Glassman, A. H., & Walsh, B. T. (1983). Link between bulimia and depression unclear. Journal of Clinical Psycho-pharmacology, 3, 203.CrossRefGoogle Scholar
  21. Goodsitt, A. (1984). Self-psychology and the treatment of anorexia nervosa. In D. M. Garner & P. E. Garfinkel (Eds.), Handbook of psychotherapy for anorexia nervosa and bulimia (pp. 55–82). New York: Guilford Press.Google Scholar
  22. Gwirtsman, H. E., Roy-Byrne, P., Yager, J., & Gerner, R. H. (1983). Neuroendocrine abnormalities in bulimia. American Journal of Psychiatry, 140, 559–563.PubMedGoogle Scholar
  23. Halmi, K. A., Falk, J. R., & Schwartz, E. (1981). Binge-eating, and vomiting: A survey of a college population. Journal of Psychological Medicine, 11, 697–706.CrossRefGoogle Scholar
  24. Herzog, D. B. (1982). Bulimia: The secretive syndrome. Psychosomatics, 23, 481–487.PubMedGoogle Scholar
  25. Hudson, J. I., Laffer, P. S., & Pope, H. G., Jr. (1982). Bulimia related to affective disorder by family history and response to the dexamethasone suppression test. American Journal of Psychiatry, 137, 695–698.Google Scholar
  26. Hudson, J., Pope, H., Jr., Jonas, J., & Yurgelun-Todd, D. (1983). Family history study of anorexia nervosa and bulimia. British Journal of Psychiatry, 142, 133–138.PubMedCrossRefGoogle Scholar
  27. Humphrey, L. L. (1986). Structural analysis of parent-child relationships in eating disorders. Journal of Abnormal Psychology, 95, 395–402.PubMedCrossRefGoogle Scholar
  28. Humphrey, L. L. (1987). Comparison of bulimic-anorexic and nondistressed families using structural analysis of social behavior. Journal of the Academy of Child and Adolescent Psychiatry, 26, 248–255.CrossRefGoogle Scholar
  29. Humphrey, L. L., & Stern, S. (1988). Object relations and the family system in bulimia: A theoretical integration. Journal of Marital and Family Therapy, 14, 337–350.CrossRefGoogle Scholar
  30. Johnson, C. (1984). The initial consultation for patients with bulimia and anorexia nervosa. In D. M. Garner & P E. Garfinkel (Eds.), Handbook of psychotherapy for anorexia nervosa and bulimia (pp. 19–51). New York: Guilford Press.Google Scholar
  31. Johnson, C., & Connors, M. (1987). Bulimia nervosa: A biopsychosocial perspective. New York: Basic Books.Google Scholar
  32. Johnson, C., & Flach, A. (1985). Family characteristics of 105 patients with bulimia. American Journal of Psychiatry, 142, 1321–1324.PubMedGoogle Scholar
  33. Johnson, C. L., & Maddi, K. L. (1986). The etiology of bulimia: A bio-psycho-social perspective. Annals of Adolescent Psychiatry, 13, 253–273.Google Scholar
  34. Johnson, C., Connors, M., & Stuckey, M. (1983). Short-term group treatment of bulimia. International Journal of Eating Disorders, 2, 199–208.CrossRefGoogle Scholar
  35. Johnson, C., Lewis, C., Love, S., Lewis, L., & Stuckey, M. (1984). Incidence and correlates of bulimic behavior in a female high school population. Journal of Youth and Adolescence, 13, 15–26.CrossRefGoogle Scholar
  36. Johnson, C., Thompson, M., & Schwartz, D. (1984). Anorexia nervosa and bulimia: An overview. In W. J. Burns & J. V Lavigne (Eds.), Progress in pediatric psychology. New York: Grune & Stratton.Google Scholar
  37. Johnson, C., Connors, M., & Tobin, D. L. (1987). Symptom management of bulimia. Journal of Consulting and Clinical Psychology, 56, 668–676.CrossRefGoogle Scholar
  38. Johnson, C., Tobin, D. L., & Enright, A. (1989). Prevalence and clinical characteristics of borderline patients in an eating disordered population. Journal of Clinical Psychiatry, 50, 9–15.PubMedGoogle Scholar
  39. Kanfer, F. H., & Scheft, B. K. (1986). Self-management theory and clinical practice. In N. S. Jacobsen (Ed.), Cognitive and behavior therapists in clinical practice. New York: Guilford Press.Google Scholar
  40. Kernberg, O. F. (1988). Object relations theory in clinical practice. Psychoanalytic Quarterly,57, 481–505.PubMedGoogle Scholar
  41. Keys, A., Brozek, J., Henschel, A., Mickelson, O., & Taylor, H. L. (1950). The biology of human starvation (Vol. 1). Minneapolis: University of Minnesota Press.Google Scholar
  42. Kog, E., & Vandereycken, W. (1981). Family characteristics of anorexia nervosa and bulimia: A review of the research literature. Clinical Psychology Review, 5, 159–180.CrossRefGoogle Scholar
  43. Kohut, H. (1971). The analysis of the self. New York: International Universities Press.Google Scholar
  44. Lee, N. E, Rush, A. J., & Mitchell, J. E. (1985). Bulimia and depression. Journal of Affective Disorders, 9, 231–238.PubMedCrossRefGoogle Scholar
  45. Levin, A. P., & Hyler, S. E. (1986). DSM III personality diagnosis in bulimia. Comparative Psychiatry,27, 47–53.CrossRefGoogle Scholar
  46. Marlatt, G. A., & Gordon, J. R. (1978). Determinants of relapse: Implications for maintenance of behavior change. In P. Davidson (Ed.), Behavioral medicine: Changing health lifestyles (pp. 410–452). New York: Brunner/Mazel.Google Scholar
  47. Meehan, V, Wilkes, N. J., & Howard, H. L. (1984). Applying new attitudes and directions. National Association of Anorexia Nervosa and Associated Disorders, Inc., Box 271, Highland Park, IL.Google Scholar
  48. Minuchin, S., Rosman, B. L., & Baker, L. (1978). Psychosomatic families: Anorexia nervosa in context. Cambridge: Harvard University Press.Google Scholar
  49. Mitchell, J. E., & Pyle, R. L. (1982). The bulimic syndrome in normal weight individuals: A review. International Journal of Eating Disorders, 1, 61–73.CrossRefGoogle Scholar
  50. Moos, R. (1974). Family Environment Scale Manual. Palo Alto, CA: Consulting Psychologists Press.Google Scholar
  51. Palazzoli, M. S. (1974). Self-starvation. London: Chaucer.Google Scholar
  52. Pope, H. G., Jr., & Hudson, J. I. (1984). New hope for binge eaters. New York: Harper & Row.Google Scholar
  53. Pyle, R. L., Mitchell, J. E., Eckert, E. D., & Halverson, P A. (1983). The incidence of bulimia in freshman college students. International Journal of Eating Disorders, 2, 75–85.CrossRefGoogle Scholar
  54. Roberto, L. G. (1986). Bulimia: The transgenerational view. Journal of Marital and Family Therapy, 12, 231–240.CrossRefGoogle Scholar
  55. Rosen, J., & Leitenberg, H. (1982). Bulimia nervosa: Treatment with exposure plus response prevention. Behavior Therapy, 13, 117–124.CrossRefGoogle Scholar
  56. Ruderman, A. (1985). Restraint, obesity, and bulimia. Behavior Research and Therapy, 23, 151–156.CrossRefGoogle Scholar
  57. Russel, G. (1979). Bulimia nervosa: An ominous variant of anorexia nervosa. Psychological Medicine,9, 429–448.CrossRefGoogle Scholar
  58. Sours, J. A. (1980). Starving to death in a sea of objects. New York: Jason Aronson.Google Scholar
  59. Spitzer, R., & Williams, J. (1985). Structured interview of DSM-III-R personality disorders. New York: Biometrics Research Department, New York State Psychiatric Institute.Google Scholar
  60. Striegel-Moore, R. H., Silberstein, L. R., & Rodin, J. (1986). Towards an understanding of risk factors for bulimia. American Psychologist,41, 246–263.PubMedCrossRefGoogle Scholar
  61. Strober, M., & Goldenburg, I. (1981). Ego boundary disturbance in juvenile anorexia nervosa. Journal of Clinical Psychology, 37, 433–438.PubMedCrossRefGoogle Scholar
  62. Strober, M., & Humphrey, L. L. (1987). Familial contributions to the etiology and course of anorexia nervosa and bulimia. Journal of Consulting and Clinical Psychology, 55, 654–659.PubMedCrossRefGoogle Scholar
  63. Strober, M., Salkin, B., Burroughs, J., & Morrel, W. (1982). Validity of the bulimia-restrictor distinction in anorexia nervosa. Journal of Nervous and Mental Disease, 170, 345–351.PubMedCrossRefGoogle Scholar
  64. Sugarman, A., & Kurash, C. (1982). The body as a transitional object in bulimia. International Journal of Eating Disorders, 1, 57–67.CrossRefGoogle Scholar
  65. Sugarman, A., Quinlan, D., & Devenis, L. (1981). Anorexia nervosa as a defense against anaclitic depression. International Journal of Eating Disorders, 1, 44–61.CrossRefGoogle Scholar
  66. Summers, E. (1988). Psychoanalytic therapy of the borderline patient: Treating the fusion-separation contradiction. Psychoanalytic Psychology, 5, 339–355.CrossRefGoogle Scholar
  67. Swift, W. J., & Letvin, R. (1984). Bulimia and the basic fault: A psychoanalytic interpretation of the bingeing-vomiting syndrome. Journal of the American Academy of Child Psychiatry, 23, 489–497.PubMedCrossRefGoogle Scholar
  68. Szmukler, G. I. (1985). Review: The epidemiology of anorexia and bulimia. Journal of Psychiatric Research, 19,113–120.CrossRefGoogle Scholar
  69. Walsh, B. T., Roose, S. P., & Glassman, A. H. (1983). Depression and eating disorders. Paper presented at the annual meeting of the American Psychiatric Association, Los Angeles.Google Scholar
  70. Weissman, M. M. (1975). The assessment of social adjustment. Archives of General Psychiatry, 32, 357–364.PubMedCrossRefGoogle Scholar
  71. Widiger, T. A., & Frances, A. (1987). Interviews and inventories for the measurement of personality disorders. Clinical Psychology Review, 7, 49–75.CrossRefGoogle Scholar
  72. Williamson, D. A., Kelly, M. L., Davis, C. J., Ruggerio, L., & Veitia, M. C. (1985). The psychophysiology of bulimia. Advances in Behavior Research and Therapy, 7, 163–172.CrossRefGoogle Scholar
  73. Zucker, P (1989). Medical complications of bulimia. Journal of College Student Psychotherapy, 3, 27–40.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1991

Authors and Affiliations

  • David L. Tobin
    • 1
  • Craig Johnson
    • 2
    • 3
  • Kevin Franke
    • 4
  1. 1.Department of PsychiatryUniversity of ChicagoChicagoUSA
  2. 2.Laureate Psychiatric Clinic and HospitalTulsaUSA
  3. 3.Department of PsychiatryNorthwestern University Medical SchoolChicagoUSA
  4. 4.Department of PsychiatryNorthwestern University Medical SchoolChicagoUSA

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